EP1140192B1 - Techniques permettant d'utiliser l'inhibiteur de cyclooxygenase-2 celecoxib et capectabine comme therapie combinee pour traiter les maladies neoplasiques - Google Patents

Techniques permettant d'utiliser l'inhibiteur de cyclooxygenase-2 celecoxib et capectabine comme therapie combinee pour traiter les maladies neoplasiques Download PDF

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EP1140192B1
EP1140192B1 EP99967543A EP99967543A EP1140192B1 EP 1140192 B1 EP1140192 B1 EP 1140192B1 EP 99967543 A EP99967543 A EP 99967543A EP 99967543 A EP99967543 A EP 99967543A EP 1140192 B1 EP1140192 B1 EP 1140192B1
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Prior art keywords
cancer
carcinoma
tumor
cell
agents
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EP1140192A2 (fr
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John P. Mckearn
Gary Gordon
James J. Cunningham
Stephen T. Gately
Alane T. Koki
Jaime L. Masferrer
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GD Searle LLC
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GD Searle LLC
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/50—Pyridazines; Hydrogenated pyridazines
    • A61K31/501—Pyridazines; Hydrogenated pyridazines not condensed and containing further heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/13—Amines
    • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/415—1,2-Diazoles
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    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/42—Oxazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445—Non condensed piperidines, e.g. piperocaine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47—Quinolines; Isoquinolines
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    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
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    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/506—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
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    • A61K31/66—Phosphorus compounds
    • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
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    • A61K41/0038—Radiosensitizing, i.e. administration of pharmaceutical agents that enhance the effect of radiotherapy
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    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
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    • A61P13/10—Drugs for disorders of the urinary system of the bladder
    • A—HUMAN NECESSITIES
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    • A61P15/14—Drugs for genital or sexual disorders; Contraceptives for lactation disorders, e.g. galactorrhoea
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    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention relates to combinations for treatment or prevention of neoplasia disorders in a mammal using two or more components with at least one component being a cyclooxygenase-2 inhibitor.
  • a neoplasm, or tumor is an abnormal, unregulated, and disorganized proliferation of cell growth.
  • a neoplasm is malignant, or cancerous, if it has properties of destructive growth, invasiveness and metastasis.
  • Invasiveness refers to the local spread of a neoplasm by infiltration or destruction of surrounding tissue, typically breaking through the basal laminas that define the boundaries of the tissues, thereby often entering the body's circulatory system.
  • Metastasis typically refers to the dissemination of tumor cells by lymphotics or blood vessels. Metastasis also refers to the migration of tumor cells by direct extension through serous cavities, or subarachnoid or other spaces. Through the process of metastasis, tumor cell migration to other areas of the body establishes neoplasms in areas away from the site of initial appearance.
  • Cancer is now the second leading cause of death in the United States and over 8,000,000 persons in the United States have been diagnosed with cancer. In 1995, cancer accounted for 23.3% of all deaths in the United States. (See U.S. Dept. of Health and Human Services, National Center for Health Statistics, Health United States 1996-97 and Injury Chartbook 117 (1997)).
  • Cancer is not fully understood on the molecular level. It is known that exposure of a cell to a carcinogen such as certain viruses, certain chemicals, or radiation, leads to DNA alteration that inactivates a "suppressive" gene or activates an "oncogene". Suppressive genes are growth regulatory genes, which upon mutation, can no longer control cell growth. Oncogenes are initially normal genes (called proto-oncogenes) that by mutation or altered context of expression become transforming genes. The products of transforming genes cause inappropriate cell growth. More than twenty different normal cellular genes can become oncogenes by genetic alteration. Transformed cells differ from normal cells in many ways, including cell morphology, cell-to-cell interactions, membrane content, cytoskeletal structure, protein secretion, gene expression and mortality (transformed cells can grow indefinitely).
  • Cancer is now primarily treated with one or a combination of three types of therapies: surgery, radiation, and chemotherapy.
  • Surgery involves the bulk removal of diseased tissue. While surgery is sometimes effective in removing tumors located at certain sites, for example, in the breast, colon, and skin, it cannot be used in the treatment of tumors located in other areas, such as the backbone, nor in the treatment of disseminated neoplastic conditions such as leukemia.
  • Chemotherapy involves the disruption of cell replication or cell metabolism. It is used most often in the treatment of breast, lung, and testicular cancer.
  • Chemotherapy-induced side effects significantly impact the quality of life of the patient and may dramatically influence patient compliance with treatment.
  • adverse side effects associated with chemotherapeutic agents are generally the major dose-limiting toxicity (DLT) in the administration of these drugs.
  • DLT dose-limiting toxicity
  • mucositis is one of the major dose limiting toxicity for several anticancer agents, including the antimetabolite cytotoxic agents 5-FU, methotrexate, and antitumor antibiotics, such as doxorubicin.
  • 5-FU the antimetabolite cytotoxic agents
  • methotrexate methotrexate
  • antitumor antibiotics such as doxorubicin.
  • Many of these chemotherapy-induced side effects if severe may lead to hospitalization, or require treatment with analgesics for the treatment of pain.
  • NMDA N-methyl-d-aspartate
  • WO 99/18960 describes a combination comprising a cyclooxygenase-2 inhibitor and an induced nitric-oxide synthase inhibitor (iNOS) that can be used to treat colorectal and breast cancer.
  • iNOS induced nitric-oxide synthase inhibitor
  • WO 99/13799 describes the combination of a cyclooxygenase-2 inhibitor and an opioid analgesic.
  • WO 98/41511 describes 5-(4-sulphunyl-phenyl)-pyridazinone derivatives used for treating cancer.
  • WO 98/41516 describes (methylsulphonyl)phenyl-2-(5H)-furanone derivatives that can be used in the treatment of cancer.
  • WO 98/16227 describes the use of cyclooxygenase-2 inhibitors in the treatment or prevention of neoplasia.
  • WO 97/36497 describes a combination comprising a cyclooxygenase-2 inhibitor and a 5-lipoxygenase inhibitor useful in treating cancer.
  • WO 97/29776 describes a composition comprising a cyclooxygenase-2 inhibitor in combination with a leukotriene B4 receptor antagonist and an immunosuppressive drug.
  • WO 97/29775 describes the use of a cyclooxygenase-2 inhibitor in combination with a leukotriene A4 hydrolase inhibitor and an immunosuppressive drug.
  • WO 97/29774 describes the combination of a cyclooxygenase-2 inhibitor and protstaglandin or antiulcer agent useful in treating cancer.
  • WO 97/11701 describes a combination comprising a cyclooxygenase-2 inhibitor and a leukotriene B4 receptor antagonist useful in treating colorectal cancer.
  • WO 96/41645 describes a combination comprising a cyclooxygenase-2 inhibitor and a leukotriene A hydrolase inhibitor.
  • WO 96/03385 describes 3,4,-Di substituted pyrazole compounds given alone or in combination with NSAIDs, steroids, 5-LO inhibitors, LTB4 antagonists, or LTA4 hydrolase inhibitors that may be useful in the treatment of cancer.
  • WO 98/47890 describes substituted benzopyran derivatives that may be used alone or in combination with other active principles.
  • WO 98/16227 describes a method of using cyclooxygenase-2 inhibitors in the treatment and prevention of neoplasia.
  • U.S. Patent No. 5,854,205 describes an isolated endostatin protein that is an inhibitor of endothelial cell proliferation and angiogenesis.
  • U.S. Patent No. 5,843,925 describes a method for inhibiting angiogenesis and endothelial cell proliferation using a 7-[substituted amino]-9-[(substituted glycyl0amido]-6-demethyl-6-deoxytetracycline.
  • U.S. Patent No. 5,863,538 describes methods and compositions for targeting tumor vasculature of solid tumors using immunological and growth factor-based reagents in combination with chemotherapy and radiation.
  • U.S. Patent No. 5,837,682 describes the use of fragments of an endothelial cell proliferation inhibitor, angiostatin.
  • U.S. Patent No. 5,861,372 describes the use of an aggregate endothelial inhibitor, angiostatin, and it use in inhibiting angiogenesis.
  • U.S. Patent No. 5,885,795 describes methods and compositions for treating diseases mediated by undesired and uncontrolled angiogenesis by administering purified angiostatin or angiostatin derivatives.
  • PCT/GB97/00650 describes the use of cinnoline derivatives for use in the production of an antiangiogenic and/or vascular permeability reducing effect.
  • PCT/US97/09610 describes administration of an anti-endogin monoclonal antibody, or fragments thereof, which is conjugated to at least one angiogenesis inhibitor or antitumor agent for use in treating tumor and angiogenesis-associated diseases.
  • PCT/IL96/00012 describes a fragment of the Thrombin B-chain for the treatment of cancer.
  • PCT/US95/16855 describes compositions and methods of killing selected tumor cells using recombinant viral vectors.
  • IL-2 interleukin-2
  • interferon alpha-2a interferon alpha-2a
  • fluorouracil in patients with metastatic renal cell carcinoma.
  • Stadler, W.M. et al. describes the response rate and toxicity of oral 13-cis-retinoic acid added to an outpatient regimen of subcutaneous interleukin-2 and interferon alpha in patients with metastatic renal cell carcinoma.
  • Rosenbeg, S.A. et al. describes treatment of patients with metastatic melanoma using chemotherapy with cisplatin, dacarbazine, and tamoxifen alone or in combination with interleukin-2 and interferon alpha-2b.
  • Elias, L. et al. describes the use of infusional 5-fluorouracil, interleukin-2, and subcutaneous interferon alpha to treat advanced renal cell carcinoma.
  • Tourani J-M. et al describes treatment of renal cell carcinoma using interleukin-2, and interferon alpha-2a administered in combination with fluorouracil.
  • Majewski, S. describes the anticancer action of retinoids, vitamin D3 and cytokines (interferons and interleukin-12) as related to the antiangiogenic and antiproliferative effects.
  • Ryan, C.W. describes treatment of patients with metastatic renal cell cancer w*ith GM-CSF, Interleukin-2, and interferon-alpha plus oral cis-retinoic acid in patients with metastatic renal cell cancer.
  • Brembeck, F.H. describes the use of 13-cis retinoic acid and interferon alpha to treat UICC stage III/IV pancreatic cancer.
  • Brembeck, F.H. describes the use of 13-cis retinoic acid and interferon alpha in patients with advanced pancreatic carcinoma.
  • Jayson, G.C. describes the use of interleukin 2 and interleukin -interferon alpha in advanced renal cancer.
  • Soori G.S. describes the use of chemo-biotherapy with chlorambucil and alpha interferon in patients with non-hodgkins lymphoma.
  • Enschede, S.H. describes the use of interferon alpha added to an anthracycline-based regimen in treating low grade and intermediate grade non-hodgkin's lymphoma.
  • Schachter, J. describes the use of a sequential multi-drug chemotherapy and biotherapy with interferon alpha, a four drug chemotherapy regimen and GM-CSF.
  • Mross, K. describes the use of retinoic acid, interferon alpha and tamoxifen in metastatic breast cancer patients.
  • Muller, H. describes the use of suramin and tamoxifen in the treatment of advanced and metastatic pancreatic carcinoma.
  • Rodriguez, M.R. describes the use of taxol and cisplatin, and taxotere and vinorelbine in the treatment of metastatic breast cancer.
  • C. describes concurrent paclitaxel and radiation therapy in locally advanced breast cancer patients.
  • Durando, A. describes combination chemotherapy with paclitaxel (T) and epirubicin (E) for metastatic breast cancer.
  • Osaki, A. describes the use of a combination therapy with mitomycin-C, etoposide, doxifluridine and medroxyprogesterone acetate as second-line therapy for advanced breast cancer.
  • the present invention provides a combination comprising a cyclooxygenase-2 inhibitor and at least one antineoplastic agent, wherein the cyclooxygenase-2 inhibitor is celecoxib and the at least one antineoplastic agent is capecitabine and the use of a combination of a cyclooxygenase-2 inhibitor and at least one antineoplastic agent for the manufacture of a medicament for the treatment or prevention of a neoplasia disorder in a mammal in need of such treatment or prevention, wherein the cyclooxygenase-2 inhibitor is celecoxib and the at least one antineoplastic agent is capecitabine.
  • a method for treating or preventing a neoplasia disorder in a mammal, including a human, in need of such treatment or prevention comprises treating the mammal with a therapeutically effective amount of a combination according to the present invention, which may comprise an additional component or components optionally selected from (a) an antiangiogenesis agent; (b) an antineoplastic agent; (c) an adjunctive agent; (d) an immunotherapeutic agent; (e) a device; (f) a vaccine; (g) an analgesic agent; and (h) a radiotherapeutic agent; provided that the additional component(s) is other than the cyclooxygenase-2 inhibitor selected as the first component and the antineoplastic agent selected as the second component.
  • a combination which may comprise an additional component or components optionally selected from (a) an antiangiogenesis agent; (b) an antineoplastic agent; (c) an adjunctive agent; (d) an immunotherapeutic agent; (e) a device; (f) a vaccine; (g)
  • the present invention is also useful for veterinary treatment of companion animals, exotic animals and farm animals, including mammals, rodents, and the like. More preferred animals include horses, dogs, and cats.
  • the combinations of the present invention may be used for the treatment or prevention of neoplasia disorders including acral lentiginous melanoma, actinic keratoses, adenocarcinoma, adenoid cycstic carcinoma, adenomas, adenosarcoma, adenosquamous carcinoma, astrocytic tumors, bartholin gland carcinoma, basal cell carcinoma, bronchial gland carcinomas, capillary, carcinoids, carcinoma, carcinosarcoma, cavernous, cholangiocarcinoma, chondosarcoma, choriod plexus papilloma/carcinoma, clear cell carcinoma, cystadenoma, endodermal sinus tumor, endometrial hyperplasia, endometrial stromal sarcoma, endometrioid adenocarcinoma, ependymal, epitheloid, Ewing's sarcoma,
  • the combinations of the present invention provide one or more benefits.
  • the Combinations of the present invention are useful in treating and preventing neoplasia disorders.
  • the combinations are administered in combination at a low dose, that is, at a dose lower than has been conventionally used in clinical situations.
  • a benefit of lowering the dose of the compounds, compositions, agents and therapies of the present invention administered to a mammal includes a decrease in the incidence of adverse effects associated with higher dosages.
  • a chemotherapeutic agent such as methotrexate
  • a reduction in the frequency and the severity of nausea and vomiting will result when compared to that observed at higher dosages.
  • the combination of the present invention can also maximize the therapeutic effect at higher doses.
  • the therapeutic agents When administered as a combination, the therapeutic agents can be formulated as separate compositions which are given at the same time or different times, or the therapeutic agents can be given as a single composition.
  • physiologically acceptable carrier is a formulation to which the compound can be added to dissolve it or otherwise facilitate its administration.
  • physiologically acceptable carriers include, water, saline, physiologically buffered saline. Additional examples are provided below.
  • pharmaceutically acceptable is used adjectivally herein to mean that the modified noun is appropriate for use in a pharmaceutical product.
  • Pharmaceutically acceptable cations include metallic ions and organic ions. More preferred metallic ions include appropriate alkali metal salts, alkaline earth metal salts and other physiological acceptable metal ions. Exemplary ions include aluminum, calcium, lithium, magnesium, potassium, sodium and zinc in their usual valences.
  • Preferred organic ions include protonated tertiary amines and quaternary ammonium cations, including in part, trimethylamine, diethylamine, N,N'-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine (N-methylglucamine) and procaine.
  • Exemplary pharmaceutically acceptable acids include hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid, methanesulfonic acid, acetic acid, formic acid, tartaric acid, maleic acid, malic acid, citric acid, isocitric acid, succinic acid, lactic acid, gluconic acid, glucuronic acid, pyruvic acid oxalacetic acid, fumaric acid, propionic acid, aspartic acid, glutamic acid, and benzoic acid.
  • a compound of the present invention can be formulated as a pharmaceutical composition. Such a composition can then be administered orally, parenterally, by inhalation spray, rectally, or topically in dosage unit formulations containing conventional nontoxic pharmaceutically acceptable carriers, adjuvants, and vehicles as desired. Topical administration can also involve the use of transdermal administration such as transdermal patches or iontophoresis devices.
  • parenteral as used herein includes subcutaneous injections, intravenous, intramuscular, intrasternal injection, or infusion techniques. Formulation of drugs is discussed in, for example, Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pennsylvania; 1975. Another example of includes Liberman, H.A. and Lachman, L., Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y., 1980.
  • sterile injectable preparations for example, sterile injectable aqueous or oleaginous suspensions can be formulated according to the known art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation can also be a sterile injectable solution or suspension in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol.
  • acceptable vehicles and solvents that can be employed are water, Ringer's solution, and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil can be employed including synthetic mono- or diglycerides.
  • fatty acids such as oleic acid find use in the preparation of injectables.
  • Suppositories for rectal administration of the drug can be prepared by mixing the drug with a suitable nonirritating excipient such as cocoa butter, synthetic mono- di- or triglycerides, fatty acids and polyethylene glycols that are sold at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum and release the drug.
  • a suitable nonirritating excipient such as cocoa butter, synthetic mono- di- or triglycerides, fatty acids and polyethylene glycols that are sold at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum and release the drug.
  • Solid dosage forms for oral administration can include capsules, tablets, pills, powders, and granules.
  • the compounds of this invention are ordinarily combined with one or more adjuvants appropriate to the indicated route of administration.
  • a contemplated aromatic sulfone hydroximate inhibitor compound can be admixed with lactose, sucrose, starch powder, cellulose esters of alkanoic acids, cellulose alkyl esters, talc, stearic acid, magnesium stearate, magnesium oxide, sodium and calcium salts of phosphoric and sulfuric acids, gelatin, acacia gum, sodium alginate, polyvinylpyrrolidone, and/or polyvinyl alcohol, and then tableted or encapsulated for convenient administration.
  • Such capsules or tablets can contain a controlled-release formulation as can be provided in a dispersion of active compound in hydroxypropylmethyl cellulose.
  • the dosage forms can also comprise buffering agents such as sodium citrate, magnesium or calcium carbonate or bicarbonate. Tablets and pills can additionally be prepared with enteric coatings.
  • formulations for parenteral administration can be in the form of aqueous or non-aqueous isotonic sterile injection solutions or suspensions. These solutions and suspensions can be prepared from sterile powders or granules having one or more of the carriers or diluents mentioned for use in the formulations for oral administration.
  • a contemplated aromatic sulfone hydroximate inhibitor compound can be dissolved in water, polyethylene glycol, propylene glycol, ethanol, corn oil, cottonseed oil, peanut oil, sesame oil, benzyl alcohol, sodium chloride, and/or various buffers. Other adjuvants and modes of administration are well and widely known in the pharmaceutical art.
  • Liquid dosage forms for oral administration can include pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs containing inert diluents commonly used in the art, such as water.
  • Such compositions can also comprise adjuvants, such as wetting agents, emulsifying and suspending agents, and sweetening, flavoring, and perfuming agents.
  • the amount of active ingredient that can be combined with the carrier materials to produce a single dosage form varies depending upon the mammalian host treated and the particular mode of administration.
  • the present invention further includes kits comprising the COX-2inhibitor and the antineoplastic agent.
  • treatment refers to any process, action, application, therapy, or the like, wherein a mammal, including a human being, is subject to medical aid with the object of improving the mammal's condition, directly or indirectly.
  • inhibitors in the context of neoplasia, tumor growth or tumor cell growth, may be assessed by delayed appearance of primary or secondary tumors, slowed development of primary or secondary tumors, decreased occurrence of primary or secondary tumors, slowed or decreased severity of secondary effects of disease, arrested tumor growth and regression of tumors, among others. In the extreme, complete inhibition, is referred to herein as prevention or chemoprevention.
  • prevention includes either preventing the onset of clinically evident neoplasia altogether or preventing the onset of a preclinically evident stage of neoplasia in individuals at risk. Also intended to be encompassed by this definition is the prevention of initiation for malignant cells or to arrest or reverse the progression of premalignant cells to malignant cells. This includes prophylactic treatment of those at risk of developing the neoplasia.
  • angiogenesis refers to the process by which tumor cells trigger abnormal blood vessel growth to create their own blood supply, and is a major target of cancer research. Angiogenesis is believed to be the mechanism via which tumors get needed nutrients to grow and metastasize to other locations in the body. Antiangiogenic agents interfere with these processes and destroy or control tumors.
  • Angiogenesis is an attractive therapeutic target because it is a multi-step process that occurs in a specific sequence, thus providing several possible targets for drug action.
  • agents that interfere with several of these steps include thrombospondin-1, angiostatin, endostatin, interferon alpha and compounds such as matrix metalloproteinase (MMP) inhibitors that block the actions of enzymes that clear and create paths for newly forming blood vessels to follow; compounds, such as ⁇ 3 inhibitors, that interfere with molecules that blood vessel cells use to bridge between a parent blood vessel and a tumor; agents, such as specific COX-2 inhibitors, that prevent the growth of cells that form new blood vessels; and protein-based compounds that simultaneously interfere with several of these targets.
  • MMP matrix metalloproteinase
  • Antiangiogenic therapy may offer several advantages over conventional chemotherapy for the treatment of cancer. Antiangiogenic agents have low toxicity in preclinical trials and development of drug resistance has not been observed (Folkman, J., Seminars in Medicine of the Beth Israel Hospital, Boston 333(26): 1757-1763, 1995). As angiogenesis is a complex process, made up of many steps including invasion, proliferation and migration of endothelial cells, it can be anticipated that combination therapies will be most effective. Kumar and Armstrong describe anti-angiogenesis therapy used as an adjunct to chemotherapy, radiation therapy, or surgery. (Kumar, CC, and Armstrong, L., Tumor-induced angiogenesis: a novel target for drug therapy?, Emerging Drugs (1997), 2, 175-190).
  • terapéuticaally-effective is intended to qualify the amount of each agent that will achieve the goal of improvement in neoplastic disease severity and the frequency of neoplastic disease over treatment of each agent by itself, while avoiding adverse side effects typically associated with alternative therapies.
  • a “therapeutic effect” or “therapeutic effective amount” is intended to qualify the amount of an anticancer agent required to relieve to some extent one or more of the symptoms of a neoplasia disorder, including, but is not limited to: 1) reduction in the number of cancer cells; 2) reduction in tumor size; 3) inhibition (i.e., slowing to some extent, preferably stopping) of cancer cell infiltration into peripheral organs; 3) inhibition (i.e., slowing to some extent, preferably stopping) of tumor metastasis; 4) inhibition, to some extent, of tumor growth; 5) relieving or reducing to some extent one or more of the symptoms associated with the disorder; and/or 6) relieving or reducing the side effects associated with the administration of anticancer agents.
  • combination therapy (or "co-therapy”) embraces the administration of a cyclooxygenase-2 inhibitor and an antineoplastic agent as part of a specific treatment regimen intended to provide a beneficial effect from the co-action of these therapeutic agents.
  • the beneficial effect of the combination includes, but is not limited to, pharmacokinetic or pharmacodynamic co-action resulting from the combination of therapeutic agents.
  • Administration of these therapeutic agents in combination typically is carried out over a defined time period (usually minutes, hours, days or weeks depending upon the combination selected).
  • “Combination therapy” generally is not intended to encompass the administration of two or more of these therapeutic agents as part of separate monotherapy regimens that incidentally and arbitrarily result in the combinations of the present invention.
  • Combination therapy is intended to embrace administration of these therapeutic agents in a sequential manner, that is, wherein each therapeutic agent is administered at a different time, as well as administration of these therapeutic agents, or at least two of the therapeutic agents, in a substantially simultaneous manner.
  • Substantially simultaneous administration can be accomplished, for example, by administering to the subject a single capsule having a fixed ratio of each therapeutic agent or in multiple, single capsules for each of the therapeutic agents.
  • Sequential or substantially simultaneous administration of each therapeutic agent can be effected by any appropriate route including, but not limited to, oral routes, intravenous routes, intramuscular routes, and direct absorption through mucous membrane tissues.
  • the therapeutic agents can be administered by the same route or by different routes.
  • a first therapeutic agent of the combination selected may be administered by intravenous injection while the other therapeutic agents of the combination may be administered orally.
  • all therapeutic agents may be administered orally or all therapeutic agents may be administered by intravenous injection.
  • the sequence in which the therapeutic agents are administered is not narrowly critical.
  • “Combination therapy” also can embrace the administration of the therapeutic agents as described above in further combination with other biologically active ingredients (such as, but not limited to, a second and different antineoplastic agent) and non-drug therapies (such as, but not limited to, surgery or radiation treatment).
  • the combination therapy further comprises radiation treatment
  • the radiation treatment may be conducted at any suitable time so long as a beneficial effect from the co-action of the combination of the therapeutic agents and radiation treatment is achieved. For example, in appropriate cases, the beneficial effect is still achieved when the radiation treatment is temporally removed from the administration of the therapeutic agents, perhaps by days or even weeks.
  • low dose in characterizing a therapeutically effective amount of the antiangiogenesis agent and the antineoplastic agent or therapy in the combination therapy, defines a quantity of such agent, or a range of quantity of such agent, that is capable of improving the neoplastic disease severity while reducing or avoiding one or more antineoplastic-agent-induced side effects, such as myelosupression, cardiac toxicity, alopecia, nausea or vomiting.
  • adjunct therapy encompasses treatment of a subject with agents that reduce or avoid side effects associated with the combination therapy of the present invention, including, but not limited to, those agents, for example, that reduce the toxic effect of anticancer drugs, e.g., bone resorption inhibitors, cardioprotective agents; prevent or reduce the incidence of nausea and vomiting associated with chemotherapy, radiotherapy or operation; or reduce the incidence of infection associated with the administration of myelosuppressive anticancer drugs.
  • agents that reduce or avoid side effects associated with the combination therapy of the present invention including, but not limited to, those agents, for example, that reduce the toxic effect of anticancer drugs, e.g., bone resorption inhibitors, cardioprotective agents; prevent or reduce the incidence of nausea and vomiting associated with chemotherapy, radiotherapy or operation; or reduce the incidence of infection associated with the administration of myelosuppressive anticancer drugs.
  • an "immunotherapeutic agent” refers to agents used to transfer the immunity of an immune donor, e.g., another person or an animal, to a host by inoculation.
  • the term embraces the use of serum or gamma globulin containing performed antibodies produced by another individual or an animal; nonspecific systemic stimulation; adjuvants; active specific immunotherapy; and adoptive immunotherapy.
  • Adoptive immunotherapy refers to the treatment of a disease by therapy or agents that include host inoculation of sensitized lymphocytes, transfer factor, immune RNA, or antibodies in serum or gamma globulin.
  • a "device” refers to any appliance, usually mechanical or electrical, designed to perform a particular function.
  • a "vaccine” includes agents that induce the patient's immune system to mount an immune response against the tumor by attacking cells that express tumor associated antigens (TAAs).
  • TAAs tumor associated antigens
  • multi-functional proteins encompass a variety of pro-angiogenic factors that include basic and acid fibroblast growth factors (bFGF and aFGF) and vascular permeability factor/vascular endothelial growth factor (VPF/VEGF) (Bikfalvi, A. et al., Endocrine Reviews 18: 26-45, 1997).
  • bFGF and aFGF basic and acid fibroblast growth factors
  • VPF/VEGF vascular permeability factor/vascular endothelial growth factor
  • endogenous antiangiogenic factors have also been characterized as multi-functional proteins and include angiostatin (O'Reilly et al., Cell (Cambridge, Mass) 79(2): 315-328, 1994), endostatin (O'Reilly et al, Cell (Cambridge, Mass) 88(2): 277-285, 1997), interferon .alpha.
  • an "analgesic agent” refers to an agent that relieves pain without producing anesthesia or loss of consciousness generally by altering the perception of nociceptive stimuli.
  • a "radiotherapeutic agent” refers to the use of electromagnetic or particulate radiation in the treatment of neoplasia.
  • pBATT embraces” or "Protein-Based Anti-Tumor Therapies,” refers to protein-based therapeutics for solid tumors.
  • the pBATTs include proteins that have demonstrated efficacy against tumors in animal models or in humans.
  • the protein is then modified to increase its efficacy and toxicity profile by enhancing its bioavailability and targeting.
  • Angiostatin is a 38 kD protein comprising the first three or four kringle domains of plasminogen and was first described in 1994 (O'Reilly, M. S. et al., Cell (Cambridge, Mass.) 79 (2): 315-328, 1994). Mice bearing primary (Lewis lung carcinoma-low metastatic) tumors did not respond to angiogenic stimuli such as bFGF in a corneal micropocket assay and the growth of metastatic tumors in these mice was suppressed until the primary tumor was excised. The factor responsible for the inhibition of angiogenesis and tumor growth was designated mouse angiostatin. Angiostatin was also shown to inhibit the growth of endothelial cells in vitro.
  • Human angiostatin can be prepared by digestion of plasminogen by porcine elastase (O'Reilly, et al., Cell 79 (2): 315-328, 1994) or with human metalloelastase (Dong et al., Cell 88, 801-810, 1997).
  • porcine elastase O'Reilly, et al., Cell 79 (2): 315-328, 1994
  • human metalloelastase Dang., ase., Cell 79 (2): 315-328, 1994
  • human angiostatin inhibited metastasis of Lewis lung carcinoma in SCID mice.
  • the same group O'Reilly, M. S. et al., Nat. Med. (N.
  • human angiostatin inhibited the growth of the human tumors PC3 prostate carcinoma, clone A colon carcinoma, and MDA-MB breast carcinoma in SCID mice.
  • Human angiostatin also inhibited the growth of the mouse tumors Lewis lung carcinoma, T241 fibrosarcoma and M5076 reticulum cell carcinoma in C57Bl mice. Because these enzymatically-prepared angiostatins are not well characterized biochemically, the precise composition of the molecules is not known.
  • Angiostatins of known composition can be prepared by means of recombinant DNA technology and expression in heterologous cell systems.
  • Recombinant human angiostatin comprising Kringle domains one through four (K1-4) has been produced in the yeast Pichia pastoris (Sim et al., Cancer Res 57 : 1329-1334, 1997).
  • the recombinant human protein inhibited growth of endothelial cells in vitro and inhibited metastasis of Lewis lung carcinoma in C57B1 mice.
  • Recombinant murine angiostatin (K1-4) has been produced in insect cells (Wu et al., Biochem Biophys Res Comm 236: 651-654, 1997).
  • the recombinant mouse protein inhibited endothelial cell growth in vitro and growth of primary Lewis lung carcinoma in vivo.
  • PCT publication WO 95/29242 discloses purification of a protein from blood and urine by HPLC that inhibits proliferation of endothelial cells.
  • the protein has a molecular weight between 38 kilodaltons and 45 kilodaltons and an amino acid sequence substantially similar to that of a murine plasminogen fragment beginning at amino acid number 79 of a murine plasminogen molecule.
  • PCT publication WO 96/41194 discloses compounds and methods for the diagnosis and monitoring of angiogenesis-dependent diseases.
  • PCT publication WO 96/35774 discloses the structure of protein fragments, generally corresponding to kringle structures occurring within angiostatin. It also discloses aggregate forms of angiostatin, which have endothelial cell inhibiting activity, and provides a means for inhibiting angiogenesis of tumors and for treating angiogenic-mediated diseases.
  • Endostatin is a 20-kDa (184 amino acid) carboxy fragment of collagen XVIII, is an angiogenesis inhibitor produced by a hemangioendothelioma (O'Reilly, M. S. et al., Cell (Cambridge, Mass.) 88(2): 277-285, 1997); and WO 97/15666). Endostatin specifically inhibits endothelial proliferation and inhibits angiogenesis and tumor growth. Primary tumors treated with non-refolded suspensions of E. coli -derived endostatin regressed to dormant microscopic lesions. Toxicity was not observed and immunohistochemical studies revealed a blockage of angiogenesis accompanied by high proliferation balanced by apoptosis in tumor cells.
  • Interferon .alpha is a family of highly homologous, species-specific proteins that possess complex antiviral, antineoplastic and immunomodulating activities (Extensively reviewed in the monograph "Antineoplastic agents, interferon alfa", American Society of Hospital Pharmacists, Inc., 1996). Interferon .alpha. also has anti-proliferative, and antiangiogenic properties, and has specific effects on cellular differentiation (Sreevalsan, in "Biologic Therapy of Cancer", pp. 347-364, (eds. V.T. DeVita Jr., S. Hellman, and S.A. Rosenberg), J.B. Lippincott Co, Philadelphia, PA, 1995).
  • Interferon .alpha. is effective against a variety of cancers including hairy cell leukemia, chronic myelogenous leukemia, malignant melanoma, and Kaposi's sarcoma.
  • the precise mechanism by which IFN.alpha. exerts its anti-tumor activity is not entirely clear, and may differ based on the tumor type or stage of disease.
  • the anti-proliferative properties of IFN.alpha. which may result from the modulation of the expression of oncogenes and/or proto-oncogenes, have been demonstrated on both tumor cell lines and human tumors growing in nude mice (Gutterman, J. U., Proc. Natl. Acad. Sci., USA 91 : 1198-1205, 1994).
  • Interferon is also considered an anti-angiogenic factor, as demonstrated through the successful treatment of hemangiomas in infants (Ezekowitz et al, N . Engl. J. Med., May 28, 326(22) 1456-1463, 1992) and the effectiveness of IFN.alpha. against Kaposi's sarcoma (Krown, Semin Oncol 14(2 Suppl 3): 27-33, 1987).
  • the mechanism underlying these anti-angiogenic effects is not clear, and may be the result of IFN.alpha. action on the tumor (decreasing the secretion of pro-angiogenic factors) or on the neo-vasculature.
  • IFN receptors have been identified on a variety of cell types (Navarro et al., Modern Pathology 9(2): 150-156, 1996).
  • United States Patent 4,530,901 by Weissmann, describes the cloning and expression of IFN-.alpha.-type molecules in transformed host strains.
  • United States Patent 4,503,035, Pestka describes an improved processes for purifying 10 species of human leukocyte interferon using preparative high performance liquid chromatography.
  • United States Patent 5,231,176, Goeddel describes the cloning of a novel distinct family of human leukocyte interferons containing in their mature form greater than 166 and no more than 172 amino acids.
  • TSP-1 Thrombospondin-1
  • TSP-1 is a trimer containing three copies of a 180 kDa polypeptide.
  • TSP-1 is produced by many cell types including platelets, fibroblasts, and endothelial cells (see Frazier, Curr Opin Cell Biol 3(5): 792-799, 1991) and the cDNA encoding the subunit has been cloned (Hennessy, et al., 1989, J Cell Biol 108(2): 729-736; Lawler and Hynes, J Cell Biol 103(5): 1635-1648, 1986).
  • TSP-1 Native TSP-1 has been shown to block endothelial cell migration in vitro and neovascularization in vivo (Good et al, Proc Natl Acad Sci USA 87(17): 6624-6628, 1990). Expression of TSP-1 in tumor cells also suppresses tumorigenesis and tumor-induced angiogenesis (Sheibani and Frazier, Proc Natl Acad Sci USA 92(15) 6788-6792, 1995; Weinstat-Saslow et al., Cancer Res 54(24):6504-6511, 1994). The antiangiogenic activity of TSP-1 has been shown to reside in two distinct domains of this protein (Tolsma et al, J Cell Biol 122(2): 497-511, 1993).
  • TSP-1 One of these domains consists of residues 303 to 309 of native TSP-1 and the other consists of residues 481 to 499 of TSP-1.
  • Another important domain consists of the sequence CSVTCG which appears to mediate the binding of TSP-1 to some tumor cell types (Tuszynski and Nicosia, Bioessays 18(1): 71-76, 1996). These results suggest that CSVTCG, or related sequences, can be used to target other moieties to tumor cells. Taken together, the available data indicate that TSP-1 plays a role in the growth and vascularization of tumors. Subfragments of TSP-1, then, may be useful as antiangiogenic components of chimeras and/or in targeting other proteins to specific tumor cells.
  • Subfragments may be generated by standard procedures (such as proteolytic fragmentation, or by DNA amplification, cloning, expression, and purification of specific TSP-1 domains or subdomains) and tested for antiangiogenic or anti-tumor activities by methods known in the art (Tolsma et al, J Cell Biol 122(2): 497-511, 1993; Tuszynski and Nicosia, Bioessays 18(1): 71-76, 1996).
  • matrix metalloproteinase inhibitor or "MMP inhibitor” includes agents that specifically inhibit a class of enzymes, the zinc metalloproteinases (metalloproteases).
  • the zinc metalloproteinases are involved in the degradation of connective tissue or connective tissue components. These enzymes are released from resident tissue cells and/or invading inflammatory or tumor cells. Blocking the action of zinc metalloproteinases interferes with the creation of paths for newly forming blood vessels to follow. Examples of MMP inhibitors are described in Golub, LM, Inhibition of Matrix Metalloproteinases: Therapeutic Applications (Annals of the New York Academy of Science, Vol 878). Robert A. Greenwald and Stanley Zucker (Eds.), June 1999), and is hereby incorporated by reference.
  • Integrin antagonist includes agents that impair endothelial cell adhesion via the various integrins. Integrin antagonists induce improperly proliferating endothelial cells to die, by interfering with molecules that blood vessel cells use to bridge between a parent blood vessel and a tumor.
  • Adhesion forces are critical for many normal physiological functions. Disruptions in these forces, through alterations in cell adhesion factors, are implicated in a variety of disorders, including cancer, stroke, osteoporosis, restenosis, and rheumatoid arthritis (A. F. Horwitz, Scientific American, 276:(5): 68-75, 1997).
  • Integrins are a large family of cell surface glycoproteins which mediate cell adhesion and play central roles in many adhesion phenomena. Integrins are heterodimers composed of noncovalently linked a and b polypeptide subunits. Currently eleven different a subunits have been identified and six different ⁇ subunits have been identified. The various a subunits can combine with various b subunits to form distinct integrins.
  • v b 3 One integrin known as a v b 3 (or the vitronectin receptor) is normally associated with endothelial cells and smooth muscle cells.
  • a v b 3 integrins can promote the formation of blood vessels (angiogenesis) in tumors. These vessels nourish the tumors and provide access routes into the bloodstream for metastatic cells.
  • the a v b 3 integrin is also known to play a role in various other disease states or conditions including tumor metastasis, solid tumor growth (neoplasia), osteoporosis, Paget's disease, humoral hypercalcemia of malignancy, angiogenesis, including tumor angiogenesis, retinopathy, arthritis, including rheumatoid arthritis, periodontal disease, psoriasis, and smooth muscle cell migration (e.g. restenosis).
  • Tumor cell invasion occurs by a three step process: 1) tumor cell attachment to extracellular matrix; 2) proteolytic dissolution of the matrix; and 3) movement of the cells through the dissolved barrier. This process can occur repeatedly and can result in metastases at sites distant from the original tumor.
  • a v b 3 integrin and a variety of other av-containing integrins bind to a number of Arg-Gly-Asp (RGD) containing matrix macromolecules.
  • RGD Arg-Gly-Asp
  • Compounds containing the RGD sequence mimic extracellular matrix ligands and bind to cell surface receptors.
  • Fibronectin and vitronectin are among the major binding partners of a v b 3 integrin.
  • Other proteins and peptides also bind the a v b 3 ligand. These include the disintegrins (M. Pfaff et al., Cell Adhes. Commun. 2(6): 491-501, 1994), peptides derived from phage display libraries (Healy, J.M.
  • the monoclonal antibody LM609 is also an a v b 3 integrin antagonist (D.A. Cheresh et al., J. Biol. Chem., 262(36): 17703-17711, 1987).
  • a v b 3 inhibitors are being developed as potential anti-cancer agents. Compounds that impair endothelial cell adhesion via the a v b 3 integrin induce improperly proliferating endothelial cells to die.
  • the a v b 3 integrin has been shown to play a role in melanoma cell invasion (Seftor et al., Proc. Natl. Acad. Sci. USA, 89: 1557-1561, 1992).
  • the a v b 3 integrin expressed on human melanoma cells has also been shown to promote a survival signal, protecting the cells from apoptosis (Montgomery et al., Proc. Natl. Acad. Sci. USA, 91 : 8856-8860, 1994).
  • v b 3 Mediation of the tumor cell metastatic pathway by interference with the a v b 3 integrin cell adhesion receptor to impede tumor metastasis would be beneficial.
  • Antagonists of a v b 3 have been shown to provide a therapeutic approach for the treatment of neoplasia (inhibition of solid tumor growth) because systemic administration of a v b 3 antagonists causes dramatic regression of various histologically distinct human tumors (Brooks et al., Cell, 79 : 1157-1164, 1994).
  • the adhesion receptor identified as integrin a v b 3 is a marker of angiogenic blood vessels in chick and man. This receptor plays a critical role in angiogenesis or neovascularization.
  • Angiogenesis is characterized by the invasion, migration and proliferation of smooth muscle and endothelial cells by new blood vessels. Antagonists of a v b 3 inhibit this process by selectively promoting apoptosis of cells in the neovasculature. The growth of new blood vessels, also contributes to pathological conditions such as diabetic retinopathy (Adonis et al., Amer . J.
  • a v b 3 antagonists can be useful therapeutic targets for treating such conditions associated with neovascularization (Brooks et al., Science, 264: 569-571, 1994).
  • the a v b 3 cell surface receptor is also the major integrin on osteoclasts responsible for the attachment to the matrix of bone. Osteoclasts cause bone resorption and when such bone resorbing activity exceeds bone forming activity, osteoporosis (a loss of bone) results, which leads to an increased number of bone fractures, incapacitation and increased mortality. Antagonists of a v b 3 have been shown to be potent inhibitors of osteoclastic activity both in vitro (Sato et al., J. Cell. Biol., 111 : 1713-1723, 1990) and in vivo (Fisher et al., Endocrinology, 132 : 1411-1413, 1993).
  • Antagonism of a v b 3 leads to decreased bone resorption and therefore assists in restoring a normal balance of bone forming and resorbing activity.
  • antagonists of osteoclast a v b 3 which are effective inhibitors of bone resorption and therefore are useful in the treatment or prevention of osteoporosis.
  • PCT Int. Appl. WO 97/08145 by Sikorski et al. discloses meta-guanidine, urea, thiourea or azacyclic amino benzoic acid derivatives as highly specific a v b 3 integrin antagonists.
  • PCT Int. Appl. WO 96/00574 A1 960111 by Cousins, R.D. et. al., describe preparation of 3-oxo-2,3,4,5-tetrahydro-1H-1,4-benzodiazepine and -2-benzazepine derivatives and analogs as vitronectin receptor antagonists.
  • PCT Int. Appl. WO 96/16983 A1 960606. by Vuori, K. and Ruoslahti, E. describe cooperative combinations of a v b 3 integrin ligand and second ligand contained within a matrix, and use in wound healing and tissue regeneration.
  • the compounds contain a ligand for the a v b 3 integrin and a ligand for the insulin receptor, the PDGF receptor, the IL-4 receptor, or the IGF receptor, combined in a biodegradable polymeric (e.g. hyaluronic acid) matrix.
  • PCT Int. Appl. WO 97/10507 A1 970320 by Ruoslahti, E; and Pasqualini, R. describe peptides that home to a selected organ or tissue in vivo, and methods of identifying them.
  • a brain-homing peptide nine amino acid residues long, for example, directs red blood cells to the brain. Also described is use of in vivo panning to identify peptides homing to a breast tumor or a melanoma.
  • PCT Int. Appl. WO 96/01653 A1 960125 by Thorpe, Philip E.; Edgington, Thomas S. describes bifunctional ligands for specific tumor inhibition by blood coagulation in tumor vasculature.
  • the disclosed bispecific binding ligands bind through a first binding region to a disease-related target cell, e.g. a tumor cell or tumor vasculature; the second region has coagulation-promoting activity or is a binding region for a coagulation factor.
  • the disclosed bispecific binding ligand may be a bispecific (monoclonal) antibody, or the two ligands may be connected by a (selectively cleavable) covalent bond, a chemical linking agent, an avidin-biotin linkage, and the like.
  • the target of the first binding region can be a cytokine-inducible component, and the cytokine can be released in response to a leukocyte-activating antibody; this may be a bispecific antibody which crosslinks activated leukocytes with tumor cells.
  • cyclooxygenase-2 inhibitor or “COX-2 inhibitor” or “cyclooxygenase-II inhibitor” includes agents that specifically inhibit a class of enzymes, cyclooxygenase-2, with less significant inhibition of cyclooxygenase-1.
  • it includes compounds which have a cyclooxygenase-2 IC 50 of less than about 0.2 ⁇ M, and also have a selectivity ratio of cyclooxygenase-2 inhibition over cyclooxygenase-1 inhibition of at least 50, and more preferably of at least 100.
  • the compounds have a cyclooxygenase-1 IC 50 of greater than about 1 ⁇ M, and more preferably of greater than 10 ⁇ M.
  • COX-2 is overexpressed in neoplastic lesions of the colon, breast, lung, prostate, esophagus, pancreas, intestine, cervix, ovaries, urinary bladder, and head & neck.
  • COX-2 inhibitors have inhibited tumor growth and metastasis.
  • COX-2 is also expressed in the angiogenic vasculature within and adjacent to hyperplastic and neoplastic lesions indicating that COX-2 plays a role in angiogenesis.
  • COX-2 inhibitors markedly inhibited bFGF-induced neovascularization.
  • the utility of COX-2 inhibitors as chemopreventive, antiangiogenic and chemotherapeutic agents is described in the literature (Koki et al., Potential utility of COX-2 inhibitors in chemoprevention and chemotherapy. Exp. Opin. Invest. Drugs (1999) 8(10) pp. 1623-1638, hereby incorporated by reference).
  • HER-2/nue HER-2/nue
  • ErbB2 HER-2/nue
  • COX-2 expression is upregulated in cells overexpressing the HER-2/neu oncogene. (Subbaramaiah et al., Increased expression of cyclooxygenase-2 in HER-2/neu-overexpressing breast cancer. Cancer Research (submitted 1999), hereby incorporated by reference).
  • COX-2 protein and mRNA were detected in HER-2/neu transformed mammary epithelial cells compared to a non-transformed partner cell line.
  • Products of COX-2 activity i.e., prostaglandins, stimulate proliferation, increase invasiveness of malignant cells, and enhance the production of vascular endothelial growth factor, which promotes angiogenesis.
  • HER-2/neu induces the production of angiogenic factors such as vascular endothelial growth factor.
  • HER-2/neu antibodies such as trastuzumab (Herceptin®) and other therapies directed at inhibiting HER-2/neu is contemplated to treat cancers in which HER-2/neu is overexpressed.
  • COX-2 levels are elevated in tumors with amplification and/or overexpression of other oncogenes including but not limited to c -myc, N-myc, L- myc , K -ras, H-ras, N -ras.
  • products of COX-2 activity stimulate cell proliferation, inhibit immune surveillance, increase invasiveness of malignant cells, and promote angiogenesis. Consequently, the administration of a COX-2 inhibitor in combination with an agent or agents that inhibits or suppresses oncogenes is contemplated to prevent or treat cancers in which oncogenes are overexpressed.
  • COX-2 inhibitors are useful for the treatment of cancer (WO98/16227) and in several animal models reduce angiogenesis driven by various growth factors (WO98/22101). Anti-angiogenesis was achieved with a COX-2 inhibitor in rats implanted with bFGF, vascular endothelium growth factor (VEGF) or carrageenan, proteins with well-known angiogenic properties.
  • bFGF vascular endothelium growth factor
  • VEGF vascular endothelium growth factor
  • carrageenan proteins with well-known angiogenic properties.
  • Pyrazoles can be prepared by methods described in WO 95/15,316. Pyrozoles can further be prepared by methods described in WO 95/15315. Pyrozoles can also be prepared by methods described in WO 96/03385.
  • Thiophene analogs can be prepared by methods described in WO 95/00501. Preparation of thiophene analogs is also described in WO 94/15932.
  • Oxazoles can be prepared by the methods described in WO 95/00501. Preparation of oxazoles is also described in WO 94/27980.
  • Isoxazoles can be prepared by the methods described in WO 96/25405. Imidazoles can be prepared by the methods described in WO 96/03388.
  • Cyclopentene cyclooxygenase-2 inhibitors can be prepared by the methods described in U.S. Patent No. 5,344,991.
  • Preparation of cyclopentane Cox-2 inhibitors is also described in WO 95/00501.
  • Terphenyl compounds can be prepared by the methods described in WO 96/16934.
  • Thiazole compounds can be prepared by the methods described in WO 96/03,392.
  • Pyridine compounds can be prepared by the methods described in WO 96/03392.
  • Preparation of pyridine compounds is also described in WO 96/24, 585.
  • the combination of the present invention comprises celecoxib as a COX-2 inhibitor.
  • Nonlimiting examples of further COX-2 inhibitors that may additionally be used in the present invention are identified in Table 1 below, which also contains a pertinent reference to celecoxib. Table No. 1. Cyclooxygenase-2 Inhibitors Compound Trade/ Research Name Reference Dosage 1,5-Diphenyl-3-substituted pyrazoles WO 97/13755 radicicol WO 96/25928.
  • COX-2 inhibitors suitable for use in the present invention described herein in addition to celecoxib, and processes for their manufacture.
  • Table No. 2 COX-2 inhibitors WO 99/30721 WO 99/30729 US 5760068 WO 98/15528 WO 99/25695 WO 99/24404 WO 99/23087 FR 27/71005 EP 921119 FR 27/70131 WO 99/18960 WO 99/15505 WO 99/15503 WO 99/14205 WO 99/14195 WO 99/14194 WO 99/13799 GB 23/30833 US 5859036 WO 99/12930 WO 99/11605 WO 99/10332 WO 99/10331 WO 99/09988 US 5869524 WO 99/05104 US 5859257 WO 98/47890 WO 98/47871 US 5830911 US 5824699 WO 98/45294.
  • the celecoxib used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,466,823.
  • valdecoxib used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,633,272.
  • the parecoxib used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,932,598.
  • the rofecoxib used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,968,974.
  • Japan Tobacco JTE-522 used in the therapeutic combinations of the present invention can be prepared in the manner set forth in JP 90/52, 882 .
  • COX-2 inhibitors that may additionally be used in the present invention include:
  • COX-2 inhibitors that may additionally be used in the present invention are selected from the group consisting of:
  • the COX-2 inhibitors that may additionally be used in the present invention include valdecoxib, parecoxib, rofecoxib, and Japan Tobacco JTE-522.
  • isomeric forms and tautomers of the described compounds and the pharmaceutically-acceptable salts thereof are also included in the combination of the invention.
  • Illustrative pharmaceutically acceptable salts are prepared from formic, acetic, propionic, succinic, glycolic, gluconic, lactic, malic, tartaric, citric, ascorbic, glucuronic, maleic, fumaric, pyruvic, aspartic, glutamic, benzoic, anthranilic, mesylic, stearic, salicylic, p-hydroxybenzoic, phenylacetic, mandelic, embonic (pamoic), methanesulfonic, ethanesulfonic, benzenesulfonic, pantothenic, toluenesulfonic, 2-hydroxyethanesulfonic, sulfanilic, cyclohexylaminosulfonic, algenic, b-hydroxybutyric, galactaric and galacturonic acids
  • Suitable pharmaceutically-acceptable base addition salts of compounds of the present invention include metallic ion salts and organic ion salts. More preferred metallic ion salts include, but are not limited to appropriate alkali metal (group Ia) salts, alkaline earth metal (group IIa) salts and other physiological acceptable metal ions. Such salts can be made from the ions of aluminum, calcium, lithium, magnesium, potassium, sodium and zinc.
  • Preferred organic salts can be made from tertiary amines and quaternary ammonium salts, including in part, trimethylamine, diethylamine, N,N'-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine (N-methylglucamine) and procaine. All of the above salts can be prepared by those skilled in the art by conventional means from the corresponding compound of the present invention.
  • a COX-2 inhibitor of the present invention can be formulated as a pharmaceutical composition. Such a composition can then be administered orally, parenterally, by inhalation spray, rectally, or topically in dosage unit formulations containing conventional nontoxic pharmaceutically acceptable carriers, adjuvants, and vehicles as desired. Topical administration can also involve the use of transdermal administration such as transdermal patches or iontophoresis devices.
  • parenteral as used herein includes subcutaneous injections, intravenous, intramuscular, intrasternal injection, or infusion techniques.
  • Formulation of drugs is discussed in, for example, Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pennsylvania 1975. Another discussion of drug formulations can be found in Liberman, H.A. and Lachman, L., Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y., 1980.
  • sterile injectable preparations for example, sterile injectable aqueous or oleaginous suspensions can be formulated according to the known art using suitable dispersing or wetting agents and suspending agents.
  • the sterile injectable preparation can also be a sterile injectable solution or suspension in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol.
  • acceptable vehicles and solvents that can be employed are water, Ringer's solution, and isotonic sodium chloride solution.
  • sterile, fixed oils are conventionally employed as a solvent or suspending medium.
  • any bland fixed oil can be employed including synthetic mono- or diglycerides.
  • fatty acids such as oleic acid find use in the preparation of injectables.
  • Suppositories for rectal administration of the drug can be prepared by mixing the drug with a suitable nonirritating excipient such as cocoa butter, synthetic mono- di- or triglycerides, fatty acids and polyethylene glycols that are solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum and release the drug.
  • a suitable nonirritating excipient such as cocoa butter, synthetic mono- di- or triglycerides, fatty acids and polyethylene glycols that are solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum and release the drug.
  • Solid dosage forms for oral administration can include capsules, tablets, pills, powders, and granules.
  • the compounds of this invention are ordinarily combined with one or more adjuvants appropriate to the indicated route of administration.
  • a contemplated aromatic sulfone hydroximate inhibitor compound can be admixed with lactose, sucrose, starch powder, cellulose esters of alkanoic acids, cellulose alkyl esters, talc, stearic acid, magnesium stearate, magnesium oxide, sodium and calcium salts of phosphoric and sulfuric acids, gelatin, acacia gum, sodium alginate, polyvinylpyrrolidone, and/or polyvinyl alcohol, and then tableted or encapsulated for convenient administration.
  • Such capsules or tablets can contain a controlled-release formulation as can be provided in a dispersion of active compound in hydroxypropylmethyl cellulose.
  • the dosage forms can also comprise buffering agents such as sodium citrate, magnesium or calcium carbonate or bicarbonate. Tablets and pills can additionally be prepared with enteric coatings.
  • formulations for parenteral administration can be in the form of aqueous or non-aqueous isotonic sterile injection solutions or suspensions. These solutions and suspensions can be prepared from sterile powders or granules having one or more of the carriers or diluents mentioned for use in the formulations for oral administration.
  • a contemplated COX-2 inhibitor compound can be dissolved in water, polyethylene glycol, propylene glycol, ethanol, corn oil, cottonseed oil, peanut oil, sesame oil, benzyl alcohol, sodium chloride, and/or various buffers.
  • Other adjuvants and modes of administration are well and widely known in the pharmaceutical art.
  • Liquid dosage forms for oral administration can include pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs containing inert diluents commonly used in the art, such as water.
  • Such compositions can also comprise adjuvants, such as wetting agents, emulsifying and suspending agents, and sweetening, flavoring, and perfuming agents.
  • the amount of active ingredient that can be combined with the carrier materials to produce a single dosage form varies depending upon the mammalian host treated and the particular mode of administration.
  • Dosage levels of COX-2 inhibitors on the order of 0.1 mg to 10,000 mg of the active antiangiogenic ingredient compound are useful in the treatment of the above conditions, with preferred levels of 1.0 mg to 1,000 mg.
  • the amount of active ingredient that may be combined with other anticancer agents to produce a single dosage form will vary depending upon the host treated and the particular mode of administration.
  • a specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drug combination, and the severity of the particular disease being treated and form of administration.
  • Treatment dosages generally may be titrated to optimize safety and efficacy. Typically, dosage-effect relationships from in vitro initially can provide useful guidance on the proper doses for patient administration. Studies in animal models also generally may be used for guidance regarding effective dosages for treatment of cancers in accordance with the present invention. In terms of treatment protocols, it should be appreciated that the dosage to be administered will depend on several factors, including the particular agent that is administered, the route administered, the condition of the particular patient, etc. Generally speaking, one will desire to administer an amount of the compound that is effective to achieve a serum level commensurate with the concentrations found to be effective in vitro.
  • the combination of the present invention comprises capecitabine as an antineoplastic agent and may additionally comprise further antineoplastic agents as discussed below.
  • antineoplastic agents includes agents that exert antineoplastic effects, i.e., prevent the development, maturation, or spread of neoplastic cells, directly on the tumor cell, e.g., by cytostatic or cytocidal effects, and not indirectly through mechanisms such as biological response modification.
  • antineoplastic agents available in commercial use, in clinical evaluation and in preclinical development, which could be included in the present invention for treatment of neoplasia by combination drug chemotherapy.
  • antineoplastic agents are classified into the following classes, subtypes and species:
  • antineoplastic agents fall into include antimetabolite agents, alkylating agents, antibiotic-type agents, hormonal anticancer agents, immunological agents, interferon-type agents, and a category of miscellaneous antineoplastic agents.
  • Some antineoplastic agents operate through multiple or unknown mechanisms and can thus be classified into more than one category.
  • a first family of antineoplastic agents which may be used in combination with the present invention consists of antimetabolite-type antineoplastic agents.
  • Antimetabolites are typically reversible or irreversible enzyme inhibitors, or compounds that otherwise interfere with the replication, translation or transcription of nucleic acids.
  • Suitable antimetabolite antineoplastic agents that may be used in the present invention include acanthifolic acid, aminothiadiazole, anastrozole, bicalutamide, brequinar sodium, capecitabine, carmofur, Ciba-Geigy CGP-30694, cladribine, cyclopentyl cytosine, cytarabine phosphate stearate, cytarabine conjugates, cytarabine ocfosfate, Lilly DATHF, Merrel Dow DDFC, dezaguanine, dideoxycytidine, dideoxyguanosine, didox, Yoshitomi DMDC, doxifluridine, Wellcome EHNA, Merck & Co.
  • EX-015 benzrabine, finasteride, floxuridine, fludarabine phosphate, N-(2'-furanidyl)-5-fluorouracil, Daiichi Seiyaku FO-152, fluorouracil (5-FU), 5-FU-fibrinogen, isopropyl pyrrolizine, Lilly LY-188011, Lilly LY-264618, methobenzaprim, methotrexate, Wellcome MZPES, nafarelin, norspermidine, nolvadex, NCI NSC-127716, NCI NSC-264880, NCI NSC-39661, NCI NSC-612567, Warner-Lambert PALA, pentostatin, piritrexim, plicamycin, Asahi Chemical PL-AC, stearate; Takeda TAC-788, thioguanine, tiazofurin, Erbamont TIF, trimetrexate,
  • Preferred antimetabolite agents that may be used in the present invention include, those identified in Table No. 3, below. Table No. 3 .
  • Antimetabolite agents Compound Common Name/ Trade Name Company Reference Dosage 1,3-Benzenediaceto nitrile,alpha, alpha, alpha', a lpha'-tetramethyl-5-(1H-1,2,4-triazol-1-ylme thyl)- anastrozole;
  • a second family of antineoplastic agents which may be used in combination with the present invention consists of alkylating-type antineoplastic agents.
  • the alkylating agents are believed to act by alkylating and cross-linking guanine and possibly other bases in DNA, arresting cell division.
  • Typical alkylating agents include nitrogen mustards, ethyleneimine compounds, alkyl sulfates, cisplatin, and various nitrosoureas.
  • a disadvantage with these compounds is that they not only attack malignant cells, but also other cells which are naturally dividing, such as those of bone marrow, skin, gastro-intestinal mucosa, and fetal tissue.
  • Suitable alkylating-type antineoplastic agents that may be used in the present invention include Shionogi 254-S, aldo-phosphamide analogues, altretamine, anaxirone, Boehringer Mannheim BBR-2207, bestrabucil, budotitane, Wakunaga CA-102, carboplatin, carmustine (BiCNU), Chinoin-139, Chinoin-153, chlorambucil, cisplatin, cyclophosphamide, American Cyanamid CL-286558, Sanofi CY-233, cyplatate, dacarbazine, Degussa D-19-384, Sumimoto DACHP(Myr)2, diphenylspiromustine, diplatinum cytostatic, Erba distamycin derivatives, Chugai DWA-2114R, ITI E09, elmustine, Erbamont FCE-24517, estramustine phosphate sodium, etop
  • a third family of antineoplastic agents which may be used in combination with the present invention consists of antibiotic-type antineoplastic agents.
  • Suitable antibiotic-type antineoplastic agents that may be used in the present invention include Taiho 4181-A, aclarubicin, actinomycin D, actinoplanone, Erbamont ADR-456, aeroplysinin derivative, Ajinomoto AN-201-II, Ajinomoto AN-3, Nippon Soda anisomycins, anthracycline, azino-mycin-A, bisucaberin, Bristol-Myers BL-6859, Bristol-Myers BMY-25067, Bristol-Myers BMY-25551, Bristol-Myers BMY-26605, Bristol-Myers BMY-27557, Bristol-Myers BMY-28438, bleomycin sulfate, bryostatin-1, Taiho C-1027, calichemycin, chromoximycin, dactin
  • antibiotic anticancer agents that may be used in the present invention include those agents identified in Table No. 5, below. Table No. 5.
  • Antibiotic anticancer agents Compound Common Name/ Trade Name Company Reference Dosage 4-Hexenoic acid, 6-(1,3-dihydro-4-hydroxy-6-methoxy-7-methyl-3-oxo-5-isobenzofuranyl )-4-methyl-, 2-(4-morpholinyl) eth yl ester, (E)- mycophenolate mofetil Roche WO 91/19498 1 to 3 gm/d mitoxan-trone US 4310666 doxorubicin US 3590028 Mitomycin and/or mitomycin-C Mutamycin Bristol-Myers Squibb Oncology/ recovery Immunology After full hematological from any previous chemotherapy: 20 2 mg/m intra-venously as a single dose via a functioning intra-venous catheter.
  • a fourth family of antineoplastic agents which may be used in combination with the present invention consists of synthetic nucleosides.
  • Several synthetic nucleosides have been identified that exhibit anticancer activity.
  • a well known nucleoside derivative with strong anticancer activity is 5-fluorouracil (5-FU).
  • 5-Fluorouracil has been used clinically in the treatment of malignant tumors, including, for example, carcinomas, sarcomas, skin cancer, cancer of the digestive organs, and breast cancer. 5-Fluorouracil, however, causes serious adverse reactions such as nausea, alopecia, diarrhea, stomatitis, leukocytic thrombocytopenia, anorexia, pigmentation, and edema.
  • U.S. Pat. No. 4,000,137 discloses that the peroxidate oxidation product of inosine, adenosine, or cytidine with methanol or ethanol has activity against lymphocytic leukemia.
  • Cytosine arabinoside also referred to as Cytarabin, araC, and Cytosar
  • Cytosine arabinoside is a nucleoside analog of deoxycytidine that was first synthesized in 1950 and introduced into clinical medicine in 1963. It is currently an important drug in the treatment of acute myeloid leukemia. It is also active against acute lymphocytic leukemia, and to a lesser extent, is useful in chronic myelocytic leukemia and non-Hodgkin's lymphoma.
  • araC The primary action of araC is inhibition of nuclear DNA synthesis.
  • Handschumacher, R. and Cheng, Y. "Purine and Pyrimidine Antimetabolites", Cancer Medicine, Chapter XV-1, 3rd Edition, Edited by J. Holland, et al., Lea and Febigol, publishers.
  • 5-Azacytidine is a cytidine analog that is primarily used in the treatment of acute myelocytic leukemia and myelodysplastic syndrome.
  • Fludara also referred to as FaraA
  • FaraA 2-Fluoroadenosine-5'-phosphate
  • the compound acts by inhibiting DNA synthesis.
  • Treatment of cells with F-araA is associated with the accumulation of cells at the G1/S phase boundary and in S phase; thus, it is a cell cycle S phase-specific drug.
  • InCorp of the active metabolite, F-araATP retards DNA chain elongation.
  • F-araA is also a potent inhibitor of ribonucleotide reductase, the key enzyme responsible for the formation of dATP.
  • 2-Chlorodeoxyadenosine is useful in the treatment of low grade B-cell neoplasms such as chronic lymphocytic leukemia, non-Hodgkins' lymphoma, and hairy-cell leukemia.
  • low grade B-cell neoplasms such as chronic lymphocytic leukemia, non-Hodgkins' lymphoma, and hairy-cell leukemia.
  • the spectrum of activity is similar to that of Fludara.
  • the compound inhibits DNA synthesis in growing cells and inhibits DNA repair in resting cells.
  • a fifth family of antineoplastic agents which may be used in combination with the present invention consists of hormonal agents.
  • suitable hormonal-type antineoplastic agents include Abarelix; Abbott A-84861; Abiraterone acetate; Aminoglutethimide; anastrozole; Asta Medica AN-207; Antide; Chugai AG-041R; Avorelin; aseranox; Sensus B2036-PEG; Bicalutamide; buserelin; BTG CB-7598; BTG CB-7630; Casodex; cetrolix; clastroban; clodronate disodium; Cosudex; Rotta Research CR-1505; cytadren; crinone; deslorelin; droloxifene; dutasteride; Elimina; Laval University EM-800; Laval University EM-652; epitiostanol; epristeride; Mediolanum EP-23904;
  • Preferred hormonal agents that may be used in the present invention include those identified in Table No. 7, below. Table No. 7. Hormonal agents Compound Common Name/ Trade Name Company Reference Dosage 2-methoxyestradiol EntreMed; 2-ME EntreMed N-(S)-tetrahydrofuroyl-Gly-D2Na1-D4C1Phe-D3Pal-Ser-NMeTyr-DLys(Nic)-Leu-Lys(Isp)-Pro-DAla-NH2 A-84861 Abbott raloxifene [3R-1-(2,2-Dimethoxyethyl)-3-((4-methylphenyl)amino carbonylmethyl)-3-(N'-(4-me thylphenyl) ureido) -indoline-2-one] AG-041R Chugai WO 94/19322 AN-207 Asta Medica WO 97/19954 Ethanamine, 2-[4-(4-chloro-1
  • a sixth family of antineoplastic agents which may be used in combination with the present invention consists of a miscellaneous family of antineoplastic agents including, but not limited to alpha-carotene, alpha-difluoromethyl-arginine, acitretin, Biotec AD-5, Kyorin AHC-52, alstonine, amonafide, amphethinile, amsacrine, Angiostat, ankinomycin, anti-neoplaston A10, antineoplaston A2, antineoplaston A3, antineoplaston A5, antineoplaston AS2-1, Henkel APD, aphidicolin glycinate, asparaginase, Avarol, baccharin, batracylin, benfluron, benzotript, Ipsen-Beaufour BIM-23015, bisantrene, Bristo-Myers BMY-40481, Vestar boron-10, bromofosfamide, Wellcome BW-502,
  • miscellaneous agents that may be used in the present invention include, but are not limited to, those identified in Table No. 8, below. Table No. 8. Miscellaneous agents Compound Common Name/ Trade Name Company Reference Dosage Flutamide; 2-methyl- N-(4-nitro-3-(trifluoromethyl)phenyl) propanamide EULEXIN® Schering Corp 750 mg/d in 3 8-hr doses.
  • Vipomas 200-300 mcgm in first two weeks of therapy
  • Zanosar Pharmacia & Upjohn i.v. 1000 mg/M2 of body surface per week for two weeks.
  • topotecan US 5004758 Selenium EP 804927 L-selenomethioni ne ACES® J.R. Carlson Laboratories calcium carbonate sulindac sulfone Exisulanc® US 5858694 ursodeoxycho lic acid US 5843929 Cell Pathways CP-461
  • Antineoplastic agents EP 0296749 EP 0882734 EP 00253738 GB 02/135425 WO 09/832762 EP 0236940 US 5338732 US 4418068 US 4692434 US 5464826 US 5061793 EP 0702961 EP 0702961 EP 0702962 EP 0095875 EP 0010458 EP 0321122 US 5041424 JP 60019790 WO 09/512606 US 4,808614 US 4526988 CA 2128644 US 5455270 WO 99/25344 WO 96/27014 US 5695966 DE 19547958 WO 95/16693 WO 82/03395 US 5789000 US 5902610 EP 189990 US 4500711 FR 24/74032 US 5925699 WO 99/25344 US 4537883 US 4808614 US 5464826 US 5
  • Table No. 10 provides illustrative examples of median dosages for selected cancer agents that may be used in combination with an antiangiogenic agent. It should be noted that specific dose regimen for the chemotherapeutic agents below depends upon dosing considerations based upon a variety of factors including the type of neoplasia; the stage of the neoplasm; the age, weight, sex, and medical condition of the patient; the route of administration; the renal and hepatic function of the patient; and the particular combination employed. Table No. 10. Median dosages for selected cancer agents.
  • the anastrozole used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,935,437.
  • the capecitabine used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,472,949.
  • the carboplatin used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,455,270.
  • the Cisplatin used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,140,704.
  • the cyclophoshpamide used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,537,883.
  • the eflornithine (DFMO) used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,413,141.
  • the docetaxel used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,814,470.
  • the doxorubicin used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 3,590,028.
  • the etoposide used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,564,675.
  • the fluorouricil used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,336,381.
  • the gemcitabine used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,526,988.
  • the goserelin used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,100,274.
  • the irinotecan used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,604,463.
  • the ketoconazole used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,144,346.
  • the letrozole used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,749,713.
  • the leucovorin used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,148,999.
  • the levamisole used in the therapeutic combinations of the present invention can be prepared in the manner set forth in GB 11/20,406.
  • the megestrol used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,696,949.
  • the mitoxantrone used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,310,666.
  • the paclitaxel used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,641,803.
  • the Retinoic acid used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,843,096.
  • the tamoxifen used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 4,418,068.
  • the topotecan used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,004,758.
  • the toremifene used in the therapeutic combinations of the present invention can be prepared in the manner set forth in EP 00/095,875.
  • the vinorelbine used in the therapeutic combinations of the present invention can be prepared in the manner set forth in EP 00/010,458.
  • the sulindac sulfone used in the therapeutic combinations of the present invention can be prepared in the manner set forth in U.S. Patent No. 5,858,694.
  • the selenium (selenomethionine) used in the therapeutic combinations of the present invention can be prepared in the manner set forth in EP 08/04,927.
  • the ursodeoxycholic acid used in the therapeutic combinations of the present invention can be prepared in the manner set forth in WO 97/34,608.
  • Ursodeoxycholic acid can also be prepared according to the manner set forth in EP 05/99,282.
  • ursodeoxycholic acid can be prepared according to the manner set forth in U.S. Patent No. 5,843,929.
  • Still more preferred antineoplastic agents include: anastrozole, calcium carbonate, capecitabine, carboplatin, cisplatin, Cell Pathways CP-461, cyclophosphamide, docetaxel, doxorubicin, etoposide, Exisulind®, fluorouracil (5-FU), fluoxymestrine, gemcitabine, goserelin, irinotecan, ketoconazole, letrozol, leucovorin, levamisole, megestrol, mitoxantrone, paclitaxel, raloxifene, retinoic acid, tamoxifen, thiotepa, topotecan, toremifene, vinorelbine, vinblastine, vincristine, selenium (selenomethionine), ursodeoxycholic acid, sulindac sulfone and eflornithine (DFMO).
  • anastrozole calcium carbonate
  • taxane includes a family of diterpene alkaloids all of which contain a particular eight (8) member “taxane” ring structure. Taxanes such as paclitaxel prevent the normal post division breakdown of microtubules which form to pull and separate the newly duplicated chromosome pairs to opposite poles of the cell prior to cell division. In cancer cells which are rapidly dividing, taxane therapy causes the microtubules to accumulate which ultimately prevents further division of the cancer cell. Taxane therapy also affects other cell processes dependant on microtubules such as cell motility, cell shape and intracellular transport. The major adverse side-effects associated with taxane therapy can be classified into cardiac effects, neurotoxicity, haematological toxicity, and hypersensitivity reactions. (See Exp.
  • COX-2 expression is elevated in cells treated with taxanes. Elevated levels of COX-2 expression are associated with inflammation and generation of other COX-2 derived prostaglandin side effects. Consequently, when taxane therapy is provided to a patient, the administration of a COX-2 inhibitor is contemplated to reduce the inflammatory and other COX-2 derived prostaglandin side effects associated with taxane therapy.
  • Taxane derivatives have been found to be useful in treating refractory ovarian carcinoma, urothelial cancer, breast carcinoma, melanoma, non-small-cell lung carcinoma, gastric, and colon carcinomas, squamous carcinoma of the head and neck, lymphoblastic, myeloblastic leukemia, and carcinoma of the esophagus.
  • Paclitaxel is typically administered in a 15-420 mg/m 2 dose over a 6 to 24 hour infusion.
  • paclitaxel is typically administered as a 250 mg/m 2 24 hour infusion every 3 weeks.
  • paclitaxel is typically dose escalated starting at 110 mg/m 2 .
  • Docetaxel is typically administered in a 60 - 100 mg/M 2 i.v. over 1 hour, every three weeks.
  • Taxanes and taxane derivatives EP 694539 EP 683232 EP 639577 EP 627418 EP 604910 EP 797988 EP 727492 EP 767786 EP 767376 US 5886026 US 5880131 US 5879929 US 5871979 US 5869680 US 5871979 US 5854278 US 5840930 US 5840748 US 5827831 US 5824701 US 5821363 US 5821263 US 5811292 US 5808113 US 5808102 US 5807888 US 5780653 US 5773461 US 5770745 US 5767282 US 5763628 US 5760252 US 5760251 US 5756776 US 5750737 US 5744592 US 5739362 US 5728850 US 5728725 US 5723634 US 5721268 US 5717115
  • U.S. Patent No. 5,019,504 describes the isolation of paclitaxel and related alkaloids from culture grown Taxus brevifolia cells.
  • U.S. Patent No. 5,675,025 describes methods for synthesis of Taxol®, Taxol® analogues and intermediates from baccatin III.
  • U.S. Patent No. 5,688,977 describes the synthesis of Docetaxel from 10-deacetyl baccatin III.
  • U.S. Patent No. 5,202,488 describes the conversion of partially purified taxane mixture to baccatin III.
  • U.S. Patent No. 5,869,680 describes the process of preparing taxane derivatives.
  • U.S. Patent No. 5,850,737 describes the method for paclitaxel synthesis.
  • U.S. Patent No. 6,688,977 describes methods for docetaxel synthesis.
  • U.S. Patent No. 5,677,462 describes the process of preparing taxane derivatives.
  • U.S. Patent No. 5,594,157 describes the process of making Taxol® derivatives.
  • retinoid includes compounds which are natural and synthetic analogues of retinol (Vitamin A).
  • the retinoids bind to one or more retinoic acid receptors to initiate diverse processes such as reproduction, development, bone formation, cellular proliferation and differentiation, apoptosis, hematopoiesis, immune function and vision.
  • Retinoids are required to maintain normal differentiation and proliferation of almost all cells and have been shown to reverse/suppress carcinogenesis in a variety of in vitro and in vivo experimental models of cancer, see (Moon et al., Ch. 14 Retinoids and cancer. In The Retinoids, Vol. 2. Academic Press, Inc. 1984). Also see Roberts et al.
  • vesanoid tretinoid trans retinoic acid
  • Lingen et al. describe the use of retinoic acid and interferon alpha against head and neck squamous cell carcinoma (Lingen, MW et al., Retinoic acid and interferon alpha act synergistically as antiangiogenic and antitumor agents against human head and neck squamous cell carcinoma. Cancer Research 58 (23) 5551-5558 (1998)).
  • Iurlaro et al. describe the use of beta interferon and 13-cis retinoic acid to inhibit angiogenesis. (Iurlaro, M et al., Beta interferon inhibits HIV-1 Tat-induced angiogenesis: synergism with 13-cis retinoic acid. European Journal of Cancer 34 (4) 570-576 (1998)).
  • Majewski et al. describe the role of retinoids and other factors in tumor angiogenesis. Majewski, S et al., Role of cytokines, retinoids and other factors in tumor angiogenesis. Central-European journal of Immunology 21 (4) 281-289 (1996)).
  • Bollag describes retinoids and alpha-interferon in the prevention and treatment of neoplastic disease.
  • Bigg, HF et al. describe all-trans retinoic acid with basic fibroblast growth factor and epidermal growth factor to stimulate tissue inhibitor of metalloproteinases from fibroblasts.
  • All-trans-retoic acid interacts synergystically with basic fibroblast growth factor and epidermal growth factor to stimulate the production of tissue inhibitor of metalloproteinases from fibroblasts. Arch. Biochem. Biophys. 319 (1) 74-83 (1995)).
  • retinoids examples include retinoids that may be used in the present invention are identified in Table No. 13 below. Table No. 13. Retinoids Compound Common Name/ Trade Name Company Reference Dosage CD-271 Adapaline EP 199636 Tretinoin trans retinoic acid Vesanoid Roche Holdings 45 mg/M 2 /day as two evenly divided doses until complete remission 2,4,6,8-Nonatetraen oic acid, 9-(4-methoxy-2,3,6-trimethylph enyl)-3,7-dimethyl- , ethyl ester, (all-E)- etretinate isoetretin; Ro-10-9359; Ro-13-7652; Tegison; Tigason Roche Holdings US 4215215 .25 - 1.5 mg/kg/day Retinoic acid, 13-cis- isotretinoin Accutane; Isotrex; Ro-4-3780; Roaccutan; Roaccutane Roche
  • Some preferred retinoids include Accutane; Adapalene; Allergan AGN-193174; Allergan AGN-193676; Allergan AGN-193836; Allergan AGN-193109; Aronex AR-623; BMS-181162; Galderma CD-437; Eisai ER-34617; Etrinate; Fenretinide; Ligand LGD-1550; lexacalcitol; Maxia Pharmaceuticals MX-781; mofarotene; Molecular Design MDI-101; Molecular Design MDI-301; Molecular Design MDI-403; Motretinide; Eisai 4-(2-[5-(4-methyl-7-ethylbenzofuran-2-yl)pyrrolyl]) benzoic acid; Johnson & Johnson N-[4-[2-thyl-1-(1H-imidazol-1-yl)butyl]phenyl]-2-benzothiazolamine; Soriatane; Roche SR- 11262; Tocoretinate;
  • cGMP phosphodiesterase inhibitors including Sulindac sulfone (Exisuland®) and CP-461 for example, are apoptosis inducers and do not inhibit the cyclooxygenase pathways.
  • cGMP phosphodiesterase inhibitors increase apoptosis in tumor cells without arresting the normal cycle of cell division or altering the cell's expression of the p53 gene.
  • Ornithine decarboxylase is a key enzyme in the polyamine synthesis pathway that is elevated in most tumors and premalignant lesions. Induction of cell growth and proliferation is associated with dramatic increases in ornithine decarboxylase activity and subsequent polyamine synthesis. Further, blocking the formation of polyamines slows or arrests growth in transformed cells. Consequently, polyamines are thought to play a role in tumor growth.
  • Difluoromethylornithine (DFMO) is a potent inhibitor of ornithine decarboxylase that has been shown to inhibit carcinogen-induced cancer development in a variety of rodent models (Meyskens et al.
  • DFMO Difluoromethylornithine
  • Bile acids are important detergents for fat solubilization and digestion in the proximal intestine.
  • Specific transprot processes in the apical domain of the terminal ileal enterocyte and basolateral domain of the hepatocyte account for the efficient conservation in the enterohepatic circulation.
  • Ursodeoxycholate (URSO), the hydrophilic 7-beta epimer of chenodeoxycholate, is non cytotoxic in a variety of cell model systems including colonic epithelia. URSO is also virtually free of side effects. URSO, at doses of 15mg/kg/day used primarily in biliary cirrhosis trials were extremely well tolerated and without toxicity. (Pourpon et al., A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. 324 New Engl. J. Med. 1548 (1991)).
  • URSO hepatic bile acid pool with this hydrophilic bile acid. It has thus been hypothesized that bile acids more hydrophilic than URSO will have even greater beneficial effects than URSO.
  • tauroursodeoxycholate TURSO
  • Non-steroidal anti-inflammatory drugs can inhibit the neoplastic transformation of colorectal epithelium. The likely mechanism to explain this chemopreventive effect is inhibition of prostaglandin synthesis.
  • NSAIDs inhibit cyclooxygenase, the enzyme that converts arachidonic acid to prostaglandins and thromboxanes.
  • NSAIDs such as sulindac or mesalamine are tempered by their well known toxicities and moderately high risk of intolerance.
  • Abdominal pain, dispepsia, nausea, diarrhea, constipation, rash, dizziness, or headaches have been reported in up to 9% of patients.
  • the elderly appear to be particularly vulnerable as the incidence of NSAID-induced gastroduodenal ulcer disease, including gastrointestinal bleeding, is higher in those over the age of 60; this is also the age group most likely to develop colon cancer, and therefore most likely to benefit from chemoprevention.
  • COX-2 inhibitors in combination with URSO is contemplated to treat or prevent cancer, including but not limited to colon cancer or colonic polyps; it is contemplated that this treatment will result in lower gastrointestinal side effects than the combination of standard NSAIDs and URSO.
  • NSAIDs have been found to prevent the production of prostaglandins by inhibiting enzymes in the human arachidonic acid/prostaglandin pathway, including the enzyme cyclooxygenase (COX).
  • COX cyclooxygenase
  • the definition of an NSAID does not include the "cyclooxygenase-2 inhibitors" described herein.
  • nonsteroidal antiinflammatory drug or "NSAID” includes agents that specifically inhibit cyclooxygenase-1, without significant inhibition of cyclooxygenase-2; or inhibit cyclooxygenase-1 and cyclooxygenase-2 at substantially the same potency; or inhibit neither cyclooxygenase-1 or cyclooxygenase-2.
  • the potency and selectivity for the enzyme cyclooxygenase-1 and cyclooxygenase-2 can be determined by assays well known in the art, see for example, Cromlish and Kennedy, Biochemical Pharmacology, Vol. 52, pp 1777-1785, 1996.
  • NSAIDs examples include sulindac, indomethacin, naproxen, diclofenac, tolectin, fenoprofen, phenylbutazone, piroxicam, ibuprofen, ketophen, mefenamic acid, tolmetin, flufenamic acid, nimesulide, niflumic acid, piroxicam, tenoxicam, phenylbutazone, fenclofenac, flurbiprofen, ketoprofen, fenoprofen, acetaminophen, salicylate and aspirin.
  • clinical tumor includes neoplasms that are identifiable through clinical screening or diagnostic procedures including, but not limited to, palpation, biopsy, cell proliferation index, endoscopy, mammagraphy, digital mammography, ultrasonography, computed tomagraphy (CT), magnetic resonance imaging (MRI), positron emmission tomaagraphy (PET), radiography, radionuclide evaluation, CT- or MRI-guided aspiration cytology, and imaging-guided needle biopsy, among others.
  • CT computed tomagraphy
  • MRI magnetic resonance imaging
  • PET positron emmission tomaagraphy
  • radiography radionuclide evaluation
  • CT- or MRI-guided aspiration cytology CT- or MRI-guided aspiration cytology
  • imaging-guided needle biopsy among others.
  • tumor marker or “tumor biomarker” encompasses a wide variety of molecules with divergent characteristics that appear in body fluids or tissue in association with a clinical tumor and also includes tumor-associated chromosomal changes. Tumor markers fall primarily into three categories: molecular or cellular markers, chromosomal markers, and serological or serum markers. Molecular and chromosomal markers complement standard parameters used to describe a tumor (i.e. histopathology, grade, tumor size) and are used primarily in refining disease diagnosis and prognosis after clinical manifestation. Serum markers can often be measured many months before clinical tumor detection and are thus useful as an early diagnostic test, in patient monitoring, and in therapy evaluation.
  • Molecular markers of cancer are products of cancer cells or molecular changes that take place in cells because of activation of cell division or inhibition of apoptosis. Expression of these markers can predict a cell's malignant potential. Because cellular markers are not secreted, tumor tissue samples are generally required for their detection.
  • Non-limiting examples of molecular tumor markers that can be used in the present invention are listed in Table No. 1, below. Table No. 1. Examples of Molecular Tumor Markers Tumor Marker Breast p53 Breast, Ovarian ErbB-2/Her-2 Breast S phase and ploidy Breast pS2 Breast MDR2 Breast urokinase plasminogen activator Breast, Colon, Lung myc family
  • chromosomal cancer markers like cellular markers, are can be used in the diagnosis and prognosis of cancer.
  • germ-line mutations can be used to predict the likelihood that a particular person will develop a given type of tumor. Examples of chromosomal tumor markers that can be used in the present invention are listed in Table No. 2, below. Table No. 2.
  • Serum markers including soluble antigens, enzymes and hormones comprise a third category of tumor markers. Monitoring serum tumor marker concentrations during therapy provides an early indication of tumor recurrence and of therapy efficacy. Serum markers are advantageous for patient surveillance compared to chromosomal and cellular markers because serum samples are more easily obtainable than tissue samples, and because serum assays can be performed serially and more rapidly. Serum tumor markers can be used to determine appropriate therapeutic doses within individual patients. For example, the efficacy of a combination regimen consisting of chemotherapeutic and antiangiogenic agents can be measured by monitoring the relevant serum cancer marker levels.
  • an efficacious therapy dose can be achieved by modulating the therapeutic dose so as to keep the particular serum tumor marker concentration stable or within the reference range, which may vary depending upon the indication.
  • the amount of therapy can then be modulated specifically for each patient so as to minimize side effects while still maintaining stable, reference range tumor marker levels.
  • Table No. 3 provides examples of serological tumor markers that can be used in the present invention. Table No. 3.
  • tumor markers useful in the present invention for the detection of germ cell cancers include, a-fetoprotein (AFP), human chorionic gonadotrophin (hCG) and its beta subunit (hCGb), lactate dehydrogenase (LDH), and placental alkaline phosphatase (PLAP).
  • AFP has an upper reference limit of approximately -10 kU/L after the first year of life and may be elevated in germ cell tumors, hepatocellular carcinoma and also in gastric, colon, biliary, pancreatic and lung cancers.
  • AFP serum half life is approximately five days after orchidectomy. According to EGTM recommendations, AFP serum levels less than 1,000 kU/L correlate with a good prognosis, AFP levels between 1,000 and 10,000 kU/L, inclusive, correlate with intermediate prognosis, and AFP levels greater than 10,000 U/L correlate with a poor prognosis.
  • HCG is synthesized in the placenta and is also produced by malignant cells. Serum hCG concentrations may be increased in pancreatic adenocarcinomas, islet cell tumors, tumors of the small and large bowel, hepatoma, stomach, lung, ovaries, breast and kidney. Because some tumors only hCGb, measurement of both hCG and hCGb is recommended. Normally, serum hCG in men and pre-menopausal women is as high as -5 U/L while post-menopausal women have levels up to -10 U/L. Serum half life of hCG ranges from 16-24 hours.
  • hCG serum levels under 5000 U/L correlate with a good prognosis
  • levels between 5000 and 50000 U/L inclusively correlate with an intermediate prognosis
  • hCG serum levels greater than 50000 U/L correlate with a poor prognosis.
  • normal hCG half lives correlate with good prognosis while prolonged half lives correlate with poor prognosis.
  • LDH is an enzyme expressed in cardiac and skeletal muscle as well as in other organs.
  • the LDH-1 isoenzyme is most commonly found in testicular germ cell tumors but can also occur in a variety of benign conditions such as skeletal muscle disease and myocardial infarction.
  • Total LDH is used to measure independent prognostic value in patients with advanced germ cell tumors. LDH levels less than 1.5 x the reference range are associated with a good prognosis, levels between 1.5 and 10 x the reference range, inclusive, are associated with an intermediate prognosis, and levels more than 10 x the reference range are associated with a poor prognosis.
  • PLAP is a enzyme of alkaline phosphatase normally expressed by placental syncytiotrophoblasts. Elevated serum concentrations of PLAP are found in seminomas, non-seminomatous tumors, and ovarian tumors, and may also provide a marker for testicular tumors. PLAP has a normal half life after surgical resection of between 0.6 and 2.8 days.
  • PSA prostate specific antigen
  • f-PSA f-PSA
  • t-PSA total PSA
  • T-PSA is useful in determining prognosis in patients that are not currently undergoing anti-androgen treatment. Rising t-PSA levels via serial measurement indicate the presence of residual disease.
  • serum tumor markers useful in the present invention for the detection of breast cancer include, but is not limited to carcinoembryonic antigen (CEA) and MUC-1 (CA 15.3).
  • CEA and CA15.3 levels are elevated in patients with node involvement compared to patients without node involvement, and in patients with larger tumors compared to smaller tumors.
  • Normal range cutoff points (upper limit) are 5-10 mg/L for CEA and 35-60 u/ml for CA15.3. Additional specificity (99.3%) is gained by confirming serum levels with two serial increases of more than 15%.
  • a example of a tumor marker useful in the present invention for the detection of ovarian cancer is CA125.
  • women have serum CA125 levels between 0-35 kU/L; 99% of post-menopausal women have levels below 20 kU/L.
  • Serum concentration of CA125 after chemotherapy is a strong predictor of outcome as elevated CA125 levels are found in roughly 80% of all patients with epithelial ovarian cancer. Further, prolonged CA125 half-life or a less than 7-fold decrease during early treatment is also a predictor of poor disease prognosis.
  • CEA carcinoembryonic antigen
  • CEA is a glycoprotein produced during embryonal and fetal development and has a high sensitivity for advanced carcinomas including those of the colon, breast, stomach and lung. High pre- or postoperative concentrations (>2.5 ng/ml) of CEA are associated with worse prognosis than are low concentrations. Further, some studies in the literature report that slow rising CEA levels indicates local recurrence while rapidly increasing levels suggests hepatic metastasis.
  • serum markers useful in the present invention to monitor lung cancer therapy include CEA, cytokeratin 19 fragments (CYFRA 21-1), and Neuron Specific Enolase (NSE).
  • NSE is a glycolytic isoenzyme of enolase produced in central and peripheral neurons and malignant tumors of neuroectodermal origin. At diagnosis, NSE concentrations greater than 25 ng/ml are suggestive of malignancy and lung cancer while concentrations greater than 100 ng/mL are suggestive of small cell lung cancer.
  • CYFRA 21-1 is a tumor marker test which uses two specific monoclonal antibodies against a cytokeratin 19 fragment. At diagnosis, CYFRA 21-1 concentrations greater than 10 ng/ml are suggestive of malignancy while concentrations greater than 30 ng/ml are suggestive of lung cancer.
  • dosing of the cyclooxygenase-2 inhibitor and antineoplastic agent may be determined and adjusted based on measurement of tumor markers in body fluids or tissues, particularly based on tumor markers in serum. For example, a decrease in serum marker level relative to baseline serum marker prior to administration of the cylcooxygenase-2 inhibitor and antineoplastic agent indicates a decrease in cancer-associated changes and provides a correlation with inhibition of the cancer.
  • the method of the present invention comprises administering the cyclooxygenase-2 inhibitor and antineoplastic agent at doses that in combination result in a decrease in one or more tumor markers, particularly a decrease in one or more serum tumor markers, in the mammal relative to baseline tumor marker levels.
  • tumor marker concentrations or serum half lives after administration of the combination indicates a good prognosis, while tumor marker concentrations which decline slowly and do not reach the normal reference range predict residual tumor and poor prognosis. Further, during follow-up therapy, increases in tumor marker concentration predicts recurrent disease many months before clinical manifestation.
  • Table No. 4 lists several references that describe tumor markers and their use in detecting and monitoring tumor growth and progression.
  • Table No. 4. Tumor marker references. European Group on Tumor Markers Publications Committee. Consensus Recommendations. Anticancer Research 19: 2785-2820 (1999) Human Cytogenetic Cancer Markers. Sandra R. Wolman and Stewart Sell (eds.). Totowa, New Jersey: Humana Press. 1997 Cellular Markers of Cancer. Carleton Garrett and Stewart Sell (eds.). Totowa, New Jersey: Human Press. 1995
  • isomeric forms, prodrugs and tautomers of the described compounds and the pharmaceutically-acceptable salts thereof are also included in the combination of the invention.
  • Illustrative pharmaceutically acceptable salts are prepared from formic, acetic, propionic, succinic, glycolic, gluconic, lactic, malic, tartaric, citric, ascorbic, glucuronic, maleic, fumaric, pyruvic, aspartic, glutamic, benzoic, anthranilic, mesylic, stearic, salicylic, p-hydroxybenzoic, phenylacetic, mandelic, embonic (pamoic), methanesulfonic, ethanesulfonic, benzenesulfonic, pantothenic, toluenesulfonic, 2-hydroxyethanesulfonic, sulfanilic, cyclohexylaminosulfonic, algenic, b-hydroxybutyric, galactaric and gal
  • Suitable pharmaceutically-acceptable base addition salts of compounds of the present invention include metallic ion salts and organic ion salts. More preferred metallic ion salts include, but are not limited to appropriate alkali metal (group Ia) salts, alkaline earth metal (group IIa) salts and other physiological acceptable metal ions. Such salts can be made from the ions of aluminum, calcium, lithium, magnesium, potassium, sodium and zinc.
  • Preferred organic salts can be made from tertiary amines and quaternary ammonium salts, including in part, trimethylamine, diethylamine, N,N'-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine (N-methylglucamine) and procaine. All of the above salts can be prepared by those skilled in the art by conventional means from the corresponding compound of the present invention.
  • compositions containing an COX-2 inhibitor alone or in combination with other therapeutic agents are administered in specific cycles until a response is obtained.
  • an COX-2 inhibitor based drug in combination with another antiangiogenic agent or one or more anticancer agents as an immediate initial therapy prior to surgery, chemotherapy, or radiation therapy, and as a continuous post-treatment therapy in patients at risk for recurrence or metastasis (for example, in adenocarcinoma of the prostate, risk for metastasis is based upon high PSA, high Gleason's score, locally extensive disease, and/or pathological evidence of tumor invasion in the surgical specimen).
  • the goal in these patients is to inhibit the growth of potentially metastatic cells from the primary tumor during surgery or radiotherapy and inhibit the growth of tumor cells from undetectable residual primary tumor.
  • an COX-2 inhibitor based drug in combination with another antiangiogenic agent or one or more anticancer agents of the present invention is used as a continuous supplement to, or possible replacement for hormonal ablation.
  • the goal in these patients is to slow or prevent tumor cell growth from both the untreated primary tumor and from the existing metastatic lesions.
  • the invention may be particularly efficacious during post-surgical recovery, where the present compositions may be particularly effective in lessening the chances of recurrence of a tumor engendered by shed cells that cannot be removed by surgical intervention.
  • COX-2 inhibitors and antineoplastic agensts may be used in conjunction with other treatment modalities, including surgery and radiation, hormonal therapy, antiangiogenic therapy, chemotherapy, immunotherapy, and cryotherapy.
  • the present invention may be used in conjunction with any current or future therapy.
  • surgery and radiation therapy are employed as potentially curative therapies for patients under 70 years of age who present with clinically localized disease and are expected to live at least 10 years.
  • Hormonal ablation is the most effective palliative treatment for the 10% of patients presenting with metastatic prostate cancer at initial diagnosis. Hormonal ablation by medication and/or orchiectomy is used to block hormones that support the further growth and metastasis of prostate cancer. With time, both the primary and metastatic tumors of virtually all of these patients become hormone-independent and resistant to therapy. Approximately 50% of patients presenting with metastatic disease die within three years after initial diagnosis, and 75% of such patients die within five years after diagnosis. Continuous supplementation with NAALADase inhibitor based drugs are used to prevent or reverse this potentially metastasis-permissive state.
  • DES diethylstilbestrol
  • leuprolide acetate
  • flutamide acetate
  • cyproterone acetate acetate
  • ketoconazole amino glutethimide
  • cyclooxygenase-2 inhibitors of the present invention may also be used in combination with monoclonal antibodies in treating cancer.
  • monoclonal antibodies may be used in treating prostate cancer.
  • a specific example of such an antibody includes cell membrane-specific anti-prostate antibody.
  • the present invention may also be used with immunotherapies based on polyclonal or monoclonal antibody-derived reagents, for instance.
  • Monoclonal antibody-based reagents are most preferred in this regard.
  • Such reagents are well known to persons of ordinary skill in the art.
  • Radiolabelled monoclonal antibodies for cancer therapy such as the recently approved use of monoclonal antibody conjugated with strontium-89, also are well known to persons of ordinary skill in the art.
  • cyclooxygenase inhibitors of the present invention may also be used in combination with other cyclooxygenase-2 inhibitors or other antiangiogenic agents in treating cancer.
  • Antiangiogenic agents include but are not limited to MMP inhibitors, integrin antagonists, COX-2 inhibitors, angiostatin, endostatin, thrombospondin-1, and interferon alpha.
  • preferred antiangiogenic agents include, but are not limited to vitaxin, marimastat, Bay-12-9566, AG-3340, metastat, celecoxib, rofecoxib, JTE-522, EMD-121974, and D-2163 (BMS-275291).
  • Cryotherapy recently has been applied to the treatment of some cancers.
  • Methods and compositions of the present invention also could be used in conjunction with an effective therapy of this type.
  • a "benign" tumor cell denotes the non-invasive and non-metastasized state of a neoplasm. In man the most frequent neoplasia site is lung, followed by colorectal, breast, prostate, bladder, pancreas, and then ovary. Other prevalent types of cancer include leukemia, central nervous system cancers, including brain cancer, melanoma, lymphoma, erythroleukemia, uterine cancer, and head and neck cancer. Examples 1 through 9 are provided to illustrate contemplated therapeutic combinations, and are not intended to limit the scope of the invention.
  • COX-2 inhibitors of the below non-limiting illustrations include but are not limited to celecoxib, rofecoxib, and JTE-522.
  • Non-small cell lung cancers e.g. squamous cell carcinoma (epidermoid), adenocarcinoma, large cell carcinoma (large cell anaplastic), etc.
  • small cell lung cancer oval cell
  • NSCLC non-small cell lung cancer
  • SCLC small cell lung cancer
  • stage I and II disease surgery is the first line of therapy and offers a relatively good chance for a cure.
  • stage IIIa and greater where the tumor has extended to tissue beyond the bronchopulmonary lymph nodes, surgery may not lead to complete excision of the tumor. In such cases, the patient's chance for a cure by surgery alone is greatly diminished.
  • other types of therapies must be utilized.
  • Radiation therapy is based on the principle that high-dose radiation delivered to a target area will result in the death of reproductive cells in both tumor and normal tissues.
  • the radiation dosage regimen is generally defined in terms of radiation absorbed dose (rad), time and fractionation, and must be carefully defined by the oncologist.
  • the amount of radiation a patient receives will depend on various consideration but the two most important considerations are the location of the tumor in relation to other critical structures or organs of the body, and the extent to which the tumor has spread.
  • a preferred course of treatment for a patient undergoing radiation therapy for NSCLC will be a treatment schedule over a 5 to 6 week period, with a total dose of 50 to 60 Gy administered to the patient in a single daily fraction of 1.8 to 2.0 Gy, 5 days a week.
  • a Gy is an abbreviation for Gray and refers to 100 rad of dose.
  • NSCLC is a systemic disease
  • radiation therapy is a local modality
  • radiation therapy as a single line of therapy is unlikely to provide a cure for NSCLC, at least for those tumors that have metastasized distantly outside the zone of treatment.
  • the use of radiation therapy with other modality regimens have important beneficial effects for the treatment of NSCLC.
  • Radiotherapy has been combined temporally with chemotherapy to improve the outcome of treatment.
  • “Sequential” therapy refers to the administration of chemotherapy and/or COX-2 therapy and/or radiation therapy separately in time in order to allow the separate administration of either chemotherapy and/or COX-2 inhibitors, and/or radiation therapy.
  • Consitant therapy refers to the administration of chemotherapy and/or a COX-2 inhibitor, and/or radiation therapy on the same day.
  • alternating therapy refers to the administration of radiation therapy on the days in which chemotherapy and/or COX-2 inhibitor would not have been administered if it was given alone.
  • Japanese Patent Kokai 5-163293 refers to some specified antibiotics of 16-membered-ring macrolides as a drug delivery carrier capable of transporting anthoracycline-type anticancer drugs into the lungs for the treatment of lung cancers.
  • the macrolide antibiotics specified herein are disclosed to be only a drug carrier, and there is no reference to the therapeutic use of macrolides against non-small cell lung cancers.
  • WO 93/18,652 refers to the effectiveness of the specified 16-membered-ring macrolides such as bafilomycin, etc. in treating non-small cell lung cancers, but they have not yet been clinically practicable.
  • interleukins are known to have an antitumor effect, but have not been reported to be effective against non-small cell lung cancers.
  • chemotherapeutic agents have been shown to be efficacious against NSCLC.
  • Preferred chemotherapeutic agents that can be used in the present invention against NSCLC include etoposide, carboplatin, methotrexate, 5-Fluorouracil, epirubicin, doxorubicin, taxol, inhibitor of normal mitotic activity; and cyclophosphamide.
  • Even more preferred chemotherapeutic agents active against NSCLC include cisplatin, ifosfamide, mitomycin C, epirubicin, vinblastine, and vindesine.
  • camptothecins a topoisomerase 1 inhibitor
  • navelbine vinorelbine
  • microtubule assebly inhibitor gemcitabine, a deoxycytidine analogue
  • fotemustine a nitrosourea compound
  • edatrexate a antifol.
  • a preferred therapy for the treatment of NSCLC is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) itosfamide, cisplatin, etoposide; 2) cyclophoshamide, doxorubicin, cisplatin; 3) isofamide, carboplatin, etoposide; 4) bleomycin, etoposide, cisplatin; 5) isofamide, mitomycin, cisplatin; 6) cisplatin, vinblastine; 7) cisplatin, vindesine; 8) mitomycin C, vinblastine, cisplatin; 9) mitomycin C, vindesine, cisplatin; 10) isofamide, etoposide; 11) etoposide, cisplatin; 12) isofamide, mitomycin C; 13) flurouracil, cisplatin, vinblastine; 14) carboplatin,
  • SCLC small cell lung cancer
  • a preferred therapy for the treatment of lung cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following antineoplastic agents: vincristine, cisplatin, carboplatin, cyclophosphamide, epirubicin (high dose), etoposide (VP-16) I.V., etoposide (VP-16) oral, isofamide, teniposide (VM-26), and doxorubicin.
  • Other preferred single-agents chemotherapeutic agents that may be used in the present invention include BCNU (carmustine), vindesine, hexamethylmelamine (altretamine), methotrexate, nitrogen mustard, and CCNU (lomustine).
  • chemotherapeutic agents under investigation that have shown activity againe SCLC include iroplatin, gemcitabine, lonidamine, and taxol.
  • Single-agent chemotherapeutic agents that have not shown activity against SCLC include mitoguazone, mitomycin C, aclarubicin, diaziquone, bisantrene, cytarabine, idarubicin, mitomxantrone, vinblastine, PCNU and esorubicin.
  • a preferred therapy for the treatment of NSCLC is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) etoposide (VP-16), cisplatin; 2) cyclophosphamide, adrianmycin [(doxorubicin), vincristine, etoposide (VP-16)]; 3) Cyclophosphamide, adrianmycin(doxorubicin), vincristine; 4) Etoposide (VP-16), ifosfamide, cisplatin; 5) etoposide (VP-16), carboplatin; 6) cisplatin, vincristine (Oncovin), doxorubicin, etoposide.
  • antineoplastic agents 1) etoposide (VP-16), cisplatin; 2) cyclophosphamide, adrianmycin [(doxorubicin), vincristine, etoposide (VP-16)];
  • radiation therapy in conjunction with the preferred combinations of COX-2 inhibitors and/or systemic chemotherapy is contemplated to be effective at increasing the response rate for SCLC patients.
  • the typical dosage regimen for radiation therapy ranges from 40 to 55 Gy, in 15 to 30 fractions, 3 to 7 times week.
  • the tissue volume to be irradiated is determined by several factors and generally the hilum and subcarnial nodes, and bialteral mdiastinal nodes up to the thoraic inlet are treated, as well as the primary tumor up to 1.5 to 2.0 cm of the margins.
  • colorectal cancer depends on the stage and grade of the tumor, for example precursor adenomas to metastatic adenocarcinoma. Generally, colorectal cancer can be treated by surgically removing the tumor, but overall survival rates remain between 45 and 60 percent. Colonic excision morbidity rates are fairly low and is generally associated with the anastomosis and not the extent of the removal of the tumor and local tissue. In patients with a high risk of reoccurrence, however, chemotherapy has been incorporated into the treatment regimen in order to improve survival rates.
  • Tumor metastasis prior to surgery is generally believed to be the cause of surgical intervention failure and up to one year of chemotherapy is required to kill the non-excised tumor cells.
  • severe toxicity is associated with the chemotherapeutic agents, only patients at high risk of recurrence are placed on chemotherapy following surgery.
  • an antiangiogenesis inhibitor into the management of colorectal cancer will play an important role in the treatment of colorectal cancer and lead to overall improved survival rates for patients diagnosed with colorectal cancer.
  • a preferred combination therapy for the treatment of colorectal cancer is surgery, followed by a regimen of one or more chemotherapeutic agents and one or more antiangiogenic agents including an MMP inhibitor, a COX-2 inhibitor, or an integrin antagonist, cycled over a one year time period.
  • a more preferred combination therapy for the treatment of colorectal cancer is a regimen of one or more COX-2 inhibitors, followed by surgical removal of the tumor from the colon or rectum and then followed be a regimen of one or more chemotherapeutic agents and one or more COX-2 inhibitors, cycled over a one year time period.
  • An even more preferred therapy for the treatment of colon cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • a more preferred therapy for the treatment of colon cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following antineoplastic agents: fluorouracil, and Levamisole.
  • fluorouracil and Levamisole are used in combination.
  • breast cancer Today, among women in the United States, breast cancer remains the most frequent diagnosed cancer. One in 8 women in the United States are at risk of developing breast cancer in their lifetime. Age, family history, diet, and genetic factors have been identified as risk factors for breast cancer. Breast cancer is the second leading cause of death among women.
  • Cytoxic agents used for treating breast cancer include doxorubicin,cyclophosphamide, methotrexate, 5-fluorouracil, mitomycin C, mitoxantrone, taxol, and epirubicin. CANCER SURVEYS, Breast Cancer volume 18, Cold Spring Harbor Laboratory Press, 1993.
  • COX-2 inhibitors can be used to treat the disease in combination with other COX-2 inhibitors, or in combination with surgery, radiation therapy or with chemotherapeutic or other antiangiogenic agents.
  • Preferred combinations of chemotherapeutic agents, radiation therapy and surgery that can be used in combination with the present invention include, but are not limited to the following combinations: 1) doxorubicin, vincristine, radical mastectomy; 2) doxorubicin, vincristine, radiation therapy; 3) cyclophosphamide, doxorubicin, 5-flourouracil, vincristine, prednisone, mastecomy; 4) cyclophosphamide, doxorubicin, 5-flourouracil, vincristine, prednisone, radiation therapy; 5) cyclophosphamide, doxorubicin, 5-flourouracil, premarin, tamoxifen, radiation therapy for pathologic complete response; 6) cycl
  • COX-2 inhibitors can be used to treat the disease in combination with other antiangiogenic agents, or in combination with surgery, radiation therapy or with chemotherapeutic agents.
  • Preferred combinations of chemotherapeutic agents, radiation therapy and surgery that can be used in combination with the present invention include, but or not limited to the following combinations: 1) cyclophosphamide, doxorubicin, 5-fluorouracil, radiation therapy; 2) cyclophosphamide, doxorubicin, 5-fluorouracil, mastectomy, radiation therapy; 3) 5-flurouracil, doxorubicin, clyclophosphamide, vincristine, prednisone, mastectomy, radiation therapy; 4) 5-flurouracil, doxorubicin, clyclophosphamide, vincristine, mastectomy, radiation therapy; 5) cyclophosphamide, doxorubicin, 5-fluorouracil, vincristine, radiation therapy;
  • COX-2 inhibitors can be used to treat the disease in combination with other antiangiogenic agents, or in combination with surgery, radiation therapy or with chemotherapeutic agents.
  • Preferred combinations of chemotherapeutic agents that can be used in combination with the angiogenesis inhibitors of the present invention include, but are not limited to the following combinations: 1) cyclosphosphamide, methotrexate, 5-fluorouracil; 2) cyclophosphamide, adriamycin, 5-fluorouracil; 3) cyclosphosphamide, methotrexate, 5-flurouracil, vincristine, prednisone; 4) adriamycin, vincristine; 5) thiotepa, adriamycin, vinblastine; 6) mitomycin, vinblastine; 7) cisplatin, etoposide.
  • Prostate cancer is now the leading form of cancer among men and the second most frequent cause of death from cancer in men. It is estimated that more than 165,000 new cases of prostate cancer were diagnosed in 1993, and more than 35,000 men died from prostate cancer in that year. Additionally, the incidence of prostate cancer has increased by 50% since 1981, and mortality from this disease has continued to increase. Previously, most men died of other illnesses or diseases before dying from their prostate cancer. We now face increasing morbidity from prostate cancer as men live longer and the disease has the opportunity to progress.
  • PSA prostate-specific antigen
  • a preferred therapy for the treatment of prostate cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • U.S. Pat. No. 4,472,382 discloses treatment of benign prostatic hyperplasia (BPH) with an antiandrogen and certain peptides which act as LH-RH agonists.
  • U.S. Pat. No. 4,596,797 discloses aromatase inhibitors as a method of prophylaxis and/or treatment of prostatic hyperplasia.
  • U.S. Pat. No. 4,760,053 describes a treatment of certain cancers which combines an LHRH agonist with an antiandrogen and/or an antiestrogen and/or at least one inhibitor of sex steroid biosynthesis.
  • U.S. Pat. No. 4,775,660 discloses a method of treating breast cancer with a combination therapy which may include surgical or chemical prevention of ovarian secretions and administering an antiandrogen and an antiestrogen.
  • U.S. Pat. No. 4,659,695 discloses a method of treatment of prostate cancer in susceptible male animals including humans whose testicular hormonal secretions are blocked by surgical or chemical means, e.g. by use of an LHRH agonist, which comprises administering an antiandrogen, e.g. flutamide, in association with at least one inhibitor of sex steroid biosynthesis, e.g. aminoglutethimide and/or ketoconazole.
  • an antiandrogen e.g. flutamide
  • at least one inhibitor of sex steroid biosynthesis e.g. aminoglutethimide and/or ketoconazole.
  • PSA Prostate Specific Antigen
  • PSA is a protein produced by prostate cells and is frequently present at elevated levels in the blood of men who have prostate cancer. PSA has been shown to correlate with tumor burden, serve as an indicator of metastatic involvement, and provide a parameter for following the response to surgery, irradiation, and androgen replacement therapy in prostate cancer patients.
  • PSA Prostate Specific Antigen
  • PSMA Prostate Specific Membrane Antigen
  • PSMA Prostate Specific Membrane Antigen
  • PSMA prostate-specific membrane antigen
  • bladder cancer The classification of bladder cancer is divided into three main classes: 1) superficial disease, 2) muscle-invasive disease, and 3) metastatic disease.
  • transurethral resection or segmental resection
  • first line therapy of superficial bladder cancer, i.e., disease confined to the mucosa or the lamina propria.
  • intravesical therapies are necessary, for example, for the treatment of high-grade tumors, carcinoma in situ, incomplete resections, recurrences, and multifocal papillary. Recurrence rates range from up to 30 to 80 percent, depending on stage of cancer.
  • Intravesical therapies include chemotherapy, immuontherapy, bacille Calmette-Guerin (BCG) and photodynamic therapy.
  • BCG Bacille Calmette-Guerin
  • the main objective of intravesical therapy is twofold: to prevent recurrence in high-risk patients and to treat disease that cannot by resected.
  • the use of intravesical therapies must be balanced with its potentially toxic side effects.
  • BCG requires an unimpaired immune system to induce an antitumor effect.
  • Chemotherapeutic agents that are known to be inactive against superficial bladder cancer include Cisplatin, actinomycin D, 5-fluorouracil, bleomycin, and cyclophosphamide methotrxate.
  • COX-2 inhibitors can be used to treat the disease in combination with other COX-2 inhibitors, or in combination with surgery (TUR), chemotherapy and intravesical therapies.
  • a preferred therapy for the treatment of superficial bladder cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with: thiotepa (30 to 60 mg/day), mitomycin C (20 to 60 mg/day), and doxorubicin (20 to 80 mg/day).
  • a preferred intravesicle immunotherapeutic agent that may be used in the present invention is BCG.
  • a preferred daily dose ranges from 60 to 120 mg, depending on the strain of the live attenuated tuberculosis organism used.
  • a preferred photodynamic therapuetic agent that may be used with the present invention is Photofrin I, a photosensitizing agent, administered intravenously. It is taken up by the low-density lipoprotein receptors of the tumor cells and is activated by exposure to visible light. Additionally, neomydium YAG laser activation generates large amounts of cytotoxic free radicals and singlet oxygen.
  • COX-2 inhibitors can be used to treat the disease in combination with other COX-2 inhibitors, or in combination with surgery (TUR), intravesical chemotherapy, radiation therapy, and radical cystectomy with pelvic lymph node dissection.
  • a preferred radiation dose for the treatment of bladder cancer is between 5,000 to 7,000 cGY in fractions of 180 to 200 cGY to the tumor. Additionally, 3,500 to 4,700 cGY total dose is administered to the normal bladder and pelvic contents in a four-field technique. Radiation therapy should be considered only if the patient is not a surgical candidate, but may be considered as preoperative therapy.
  • a preferred combination of surgery and chemotherapeutic agents that can be used in combination with the COX-2 inhibitors of the present invention is cystectomy in conjunction with five cycles of cisplatin (70 to 100 mg/m(square)); doxorubicin (50 to 60 mg/m(square); and cyclophosphamide (500 to 600 mg/m(square).
  • a more preferred therapy for the treatment of superficial bladder cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • An even more preferred combination for the treatment of superficial bladder cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) cisplatin, doxorubicin, cyclophosphamide; and 2) cisplatin, 5-fluorouracil.
  • An even more preferred combination of chemotherapeutic agents that can be used in combination with radiation therapy and the COX-2 inhibitors is a combination of cisplatin, methotrexate, vinblastine.
  • the present invention contemplates an effective treatment of bladder cancer leading to improved tumor inhibition or regression, as compared to current therapies.
  • COX-2 inhibitors can be used to treat the disease in combination with other antiangiogenic agents, or in combination with surgery, radiation therapy or with chemotherapeutic agents.
  • a preferred therapy for the treatment of metastatic bladder cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • a more preferred combination for the treatment of metastatic bladder caner is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplasitc agents: 1) cisplatin and methotrexate; 2) doxorubicin, vinblastine, cyclophoshamide, and 5-fluorouracil; 3) vinblastine, doxorubicin, cisplatin, methotrexate; 4) vinblastine, cisplatin, methotrexate; 5) cyclophosphamide, doxorubicin, cisplatin; 6) 5-fluorouracil, cisplatin.
  • pancreatic cancer Approximately 2% of new cancer cases diagnoses in the United States is pancreatic cancer.
  • Pancreatic cancer is generally classified into two clinical types: 1) adenocarcinoma (metastatic and non-metastatic), and 2) cystic neoplasms (serous cystadenomas, mucinous cystic neoplasms, papilary cystic neoplasms, acinar cell systadenocarcinoma, cystic choriocarcinoma, cystic teratomas, angiomatous neoplasms).
  • adenocarcinoma metalstatic and non-metastatic
  • cystic neoplasms serine cystadenomas, mucinous cystic neoplasms, papilary cystic neoplasms, acinar cell systadenocarcinoma, cystic choriocarcinoma, cystic teratomas, angiomatous ne
  • Preferred combinations of therapy for the treatment of non-metastatic adenocarcinoma include the use of a COX-2 inhibitor along with preoperative bilary tract decompression (patients presenting with obstructive jaundice); surgical resection, including standard resection, extended or radial resection and distal pancreatectomy (tumors of body and tail); adjuvant radiation; antiangiogenic therapy; and chemotherapy.
  • a preferred combination therapy consists of a COX-2 inhibitor of the present invention in combination with continuous treatment of 5- fluorouracil, followed by weekly cisplatin therapy.
  • a more preferred combination therapy for the treatment of cystic neoplasms is the use of a COX-2 inhibitor along with resection.
  • Celomic epithelial carcinoma accounts for approximately 90% of ovarian cancer cases.
  • a preferred therapy for the treatment of ovary cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • Preferred single agents that can be used in combination with a COX-2 inhibitor include, but are not limited to: alkylating agents, ifosfamide, cisplatin, carboplatin, taxol, doxorubicin, 5-fluorouracil, methotrexate, mitomycin, hexamethylmelamine, progestins, antiestrogens, prednimustine, dihydroxybusulfan, galactitol, interferon alpha, and interferon gama.
  • Preferred combinations for the treatment of celomic epithelial carcinoma is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) cisplatin, doxorubicin, cyclophosphamide; 2) hexamthylmelamine, cyclosphamide, doxorubicin, cisplatin; 3) cyclophosphamide, hexamehtylmelamine, 5-flurouracil, cisplatin; 4) melphalan, hexamethylmelamine, cyclophosphamide; 5) melphalan, doxorubicin, cyclophosphamide; 6) cyclophosphamide, cisplatin, carboplatin; 7) cyclophosphamide, doxorubicin, hexamethylmelamine, cisplatin; 8) cyclophosphamide, doxorubicin
  • Germ cell ovarian cancer accounts for approximately 5% of ovarian cancer cases. Germ cell ovarian carcinomas are classified into two main groups: 1) dysgerminoma, and nondysgerminoma. Nondysgerminoma is further classified into teratoma, endodermal sinus tumor, embryonal carcinoma, chloricarcinoma, polyembryoma, and mixed cell tumors.
  • a preferred therapy for the treatment of germ cell carcinoma is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • a more preferred therapy for the treatment of germ cell carcinoma is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) vincristine, actinomycin D, cyclophosphamide; 2) bleomycin, etoposide, cisplatin; 3) vinblastine, bleomycin, cisplatin.
  • Cancer of the fallopian tube is the least common type of ovarian cancer, accounting for approximately 400 new cancer cases per year in the United States.
  • Papillary serous adenocarcinoma accounts for approximately 90% of all malignancies of the ovarian tube.
  • a preferred therapy for the treatment of fallopian tube cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • a more preferred therapy for the treatment of fallopian tube cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with on or more of the following of antineoplastic agents: alkylating agents, ifosfamide, cisplatin, carboplatin, taxol, doxorubicin, 5-fluorouracil, methotrexate, mitomycin, hexamethylmelamine, progestins, antiestrogens, prednimustine, dihydroxybusulfan, galactitol, interferon alpha, and interferon gama.
  • antineoplastic agents alkylating agents, ifosfamide, cisplatin, carboplatin, taxol, doxorubicin, 5-fluorouracil, methotrexate, mitomycin, hexamethylmelamine, progestins, antiestrogens, prednimustine, dihydroxybusulfan, galactitol, interferon alpha,
  • An even more preferred therapy for the treatment of fallopian tube cancer is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of antineoplastic agents: 1) cisplatin, doxorubicin, cyclophosphamide; 2) hexamthylmelamine, cyclosphamide, doxorubicin, cisplatin; 3) cyclophosphamide, hexamehtylmelamine, 5-flurouracil, cisplatin; 4) melphalan, hexamethylmelamine, cyclophosphamide; 5) melphalan, doxorubicin, cyclophosphamide; 6) cyclophosphamide, cisplatin, carboplatin; 7) cyclophosphamide, doxorubicin, hexamethylmelamine, cisplatin; 8) cyclophosphamide, doxorubicin,
  • Central nervous system cancer accounts for approximately 2% of new cancer cases in the United States.
  • Common intracranial neoplasms include glioma, meninigioma, neurinoma, and adenoma.
  • a preferred therapy for the treatment of central nervous system cancers is a combination of therapeutically effective amounts of one or more COX-2 inhibitors.
  • a preferred therapy for the treatment of maligant glioma is a combination of therapeutically effective amounts of one or more COX-2 inhibitors in combination with the following combinations of therapies and antineoplastic agents:: 1) radiation therapy, BCNU (carmustine); 2) radiation therapy, methyl CCNU (lomustine); 3) radiation therapy, medol; 4) radiation therapy, procarbazine; 5) radiation therapy, BCNU, medrol; 6) hyperfraction radiation therapy, BCNU; 7) radiation therapy, misonidazole, BCNU; 8) radiation therapy, streptozotocin; 9) radiation therapy, BCNU, procarbazine; 10) radiation therapy, BCNU, hydroxyurea, procarbazine, VM-26; 11) radiation therapy, BNCU, 5-flourouacil; 12) radiation therapy, Methyl CCNU, dacarbazine; 13) radiation therapy, misonidazole, BCNU; 14) diaziquone; 15) radiation therapy, PCNU; 16) pro
  • a preferred dose of radiation therapy is about 5,500 to about 6,000 cGY.
  • Preferred radiosensitizers include misonidazole, intra-arterial Budr and intravenous iododeoxyuridine (IUdR). It is also contemplated that radiosurgery may be used in combinations with antiangiogenesis agents.
  • mice were injected subcutaneously in the left paw (1 x 10 6 tumor cells suspended in 30 % Matrigel) and tumor volume was evaluated using a phlethysmometer twice a week for 30-60 days. Blood was drawn twice during the experiment in a 24 h protocol to assess plasma concentration and total exposure by AUC analysis. The data are expressed as the mean +/- SEM. Student's and Mann-Whitney tests were used to assess differences between means using the InStat software package. Celecoxib given in the diet at doses between 160-3200 ppm retarded the growth of these tumors. The inhibitory effect of celecoxib was dose-dependent and ranged from 48 % to 85 % as compared with the control tumors.
  • mice were injected subcutaneously in the left paw (1 x 10 6 tumor cells suspended in 30 % Matrigel) and tumor volume was evaluated using a phlethysmometer twice a week for 30-60 days. Implantation of human colon cancer cells (HT-29) into nude mice produces tumors that will reach 0.6-2 ml between 30-50 days. Blood was drawn twice during the experiment in a 24 h protocol to assess plasma concentration and total exposure by AUC analysis. The data are expressed as the mean +/- SEM. Student's and Mann-Whitney tests were used to assess differences between means using the InStat software package. A.
  • mice injected with HT-29 cancer cells were treated with cytoxin i.p at doses of 50 mg/kg on days 5,7 and 9 in the presence or absence of celecoxib in the diet.
  • the efficacy of both agents were determined by measuring tumor volume.
  • Treatment using a celecoxib related COX-2 inhibitor (SC-58236) reduced tumor volume by 89 %.
  • indomethacin given at near the maximum tolerated dose of 2 mg/kg/day in the drinking water inhibited tumor formation by 77%.
  • the COX-2 selective inhibitor completely inhibited the formation of lung metastasis while the non-selective NSAID indomethacin was ineffective.
  • mice injected with HT-29 cancer cells were treated with 5-FU on days 12 through 15.
  • mice injected with HT-29 cancer cells were treated with 5-FU i.p at doses of 50 mg/kg on days 12, 13, 14, and 15 in the presence or absence of celecoxib in the diet.
  • the efficacy of both agents were determined by measuring tumor volume. Treatment using a celecoxib reduced tumor volume by 68 %.
  • mice injected with HT-29 colon cancer cells were treated with 5-FU i.p 50 mg/kg on days 14 through 17 in the presence or absence of celecoxib (1600ppm) and valdecoxib (160 ppm) in the diet. The efficacy of both agents were determined by measuring tumor volume. Treatment with 5-FU resulted in a 35% reduction in tumor voloume. Treatment with celecoxib and valdecoxib reduced tumor volume by 52 % and 69 %, respectively.
  • mice injected with HT-29 colon cancer cells were treated with celecoxib (10, 40 or 160 ppm) in the diet beginning at day 10.

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Claims (7)

  1. Utilisation d'une combinaison d'un inhibiteur de cyclooxygénase-2 et d'au moins un agent antinéoplasique pour la fabrication d'un médicament pour le traitement ou la prévention d'un trouble de type néoplasie chez un mammifère nécessitant un tel traitement ou une telle prévention, où l'inhibiteur de cyclooxygénase-2 est le celecoxib et le ou les agents antinéoplasiques sont la capecitabine.
  2. Utilisation selon la revendication 1 où le médicament est adapté pour l'administration de la combinaison d'une manière successive.
  3. Utilisation selon la revendication 1 où le médicament est adapté pour l'administration de la combinaison d'une manière sensiblement simultanée.
  4. Utilisation selon la revendication 1 où la néoplasie est choisie dans le groupe consistant en le cancer du poumon, le cancer du sein, le cancer gastro-intestinal, le cancer de la vessie, le cancer de la tête et du cou et le cancer cervical.
  5. Utilisation selon la revendication 1 où la néoplasie est choisie dans le groupe consistant en le mélanome lentigineux des extrémités, les kératoses actiniques, l'adénocarcinome, le carcinome kystique adénoïde, les adénomes, l'adénosarcome, le carcinome adénosquameux, les tumeurs astrocytiques, le carcinome de la glande de Bartholin, le carcinome à cellules basales, les carcinomes de glandes bronchiques, les capillaires, les carcinoïdes, le carcinome, le carcinosarcome, caverneux, le cholangiocarcinome, le chondosarcome, le papillome/carcinome du plexus choroïde, le carcinome à cellules claires, le cystadénome, la tumeur du sinus endodermique, l'hyperplasie endométriale, le sarcome stromal endométrial, l'adénocarcinome endométrioïde, l'épendymal, l'épithéloïde, le sarcome de Ewing, l'hyperplasie nodale focale, fibrolamellaire, le gastrinome, les tumeurs à cellules germinales, le glioblastome, le glucagonome, les hémangioblastomes, l'hémangioendothéliome, les hémangiomes, l'adénome hépatique, l'adénomatose hépatique, le carcinome hépatocellulaire, l'insulinome, la néoplasie intraépithéliale, les néoplasies à cellules squameuses interépithéliales, le carcinome à cellules squameuses invasives, le carcinome à grandes cellules, le léiomyosarcome, les mélanomes malins lentigos, le mélanome malin, les tumeurs mésothéliales malignes, le médulloblastome, le médulloépithéliome, le mélanome, le carcinome méningé, mésothélial, métastatique, le carcinome mucoépidermoïde, le neuroblastome, l'adénocarcinome neuroépithélial, le mélanome nodulaire, le carcinome anaplasique à petites cellules, l'ostréosarcome, oligodendroglial, le polypeptide pancréatique, l'adénocarcinome séreux papillaire, les cellules pinéales, les tumeurs hypophysaires, le plasmacytome, le pseudosarcome, le blastome pulmonaire, le carcinome à cellules rénales, le rétinoblastome, le rhabdomyosarcome, le sarcome, le carcinome séreux, le carcinome à petites cellules, les carcinomes à tissu mou, les tumeurs sécrétant de la somatostatine, le carcinome squameux, le carcinome à cellules squameuses, le mélanome submésothélial, à propagation superficielle, le carcinome indifférencié, le mélanome uvéal, le carcinome verruqueux, le vipome, le carcinome bien différencié et la tumeur de Wilm.
  6. Utilisation selon l'une quelconque des revendications 1 à 5 où le traitement ou la prévention comprend en outre une radiothérapie.
  7. Combinaison comprenant un inhibiteur de cyclooxygénase-2 et au moins un agent antinéoplasique où l'inhibiteur de cyclooxygénase-2 est le celecoxib et le ou les agents néoplasiques sont la capecitabine.
EP99967543A 1998-12-23 1999-12-22 Techniques permettant d'utiliser l'inhibiteur de cyclooxygenase-2 celecoxib et capectabine comme therapie combinee pour traiter les maladies neoplasiques Expired - Lifetime EP1140192B1 (fr)

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EP99966587A Ceased EP1140178A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un inhibiteur matriciel de la metalloproteinase et la radiotherapie comme therapie combinee pour traiter les maladies neoplasiques
EP99968529A Withdrawn EP1140193A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un antagoniste de l'integrine et un ou plusieurs agents antineoplasiques comme therapie combinee pour traiter les maladies neoplasiques
EP99967543A Expired - Lifetime EP1140192B1 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser l'inhibiteur de cyclooxygenase-2 celecoxib et capectabine comme therapie combinee pour traiter les maladies neoplasiques
EP99966594A Withdrawn EP1140179A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un inhibiteur de cyclooxygenase-2 et un antagoniste de l'integrine comme therapie combinee pour traiter les maladies neoplasiques
EP99968941A Withdrawn EP1140182A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un inhibiteur matriciel de la metalloproteinase et un ou plusieurs agents antineoplasiques comme therapie combinee pour traiter les maladies neoplasiques
EP99968942A Ceased EP1140183A1 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un inhibiteur matriciel de la metalloproteinase et un antagoniste de l'integrine pour traiter les maladies neoplasiques
EP99966558A Withdrawn EP1140177A2 (fr) 1998-12-23 1999-12-22 Procede d'utilisation d'un antagoniste de l'integrine et radiotherapie en tant que polytherapie dans le traitement des neoplasies

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EP99966587A Ceased EP1140178A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un inhibiteur matriciel de la metalloproteinase et la radiotherapie comme therapie combinee pour traiter les maladies neoplasiques
EP99968529A Withdrawn EP1140193A2 (fr) 1998-12-23 1999-12-22 Techniques permettant d'utiliser un antagoniste de l'integrine et un ou plusieurs agents antineoplasiques comme therapie combinee pour traiter les maladies neoplasiques

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EP2047271B1 (fr) * 2006-08-02 2012-11-14 Sanoxsys GmbH Procédé de détermination de la sensibilité de tumeurs à la capécitabine
WO2014150996A1 (fr) * 2013-03-15 2014-09-25 Cba Pharma, Inc. Traitement contre le cancer

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7115632B1 (en) * 1999-05-12 2006-10-03 G. D. Searle & Co. Sulfonyl aryl or heteroaryl hydroxamic acid compounds
US6696449B2 (en) 1997-03-04 2004-02-24 Pharmacia Corporation Sulfonyl aryl hydroxamates and their use as matrix metalloprotease inhibitors
US6794511B2 (en) 1997-03-04 2004-09-21 G. D. Searle Sulfonyl aryl or heteroaryl hydroxamic acid compounds
US20040072889A1 (en) * 1997-04-21 2004-04-15 Pharmacia Corporation Method of using a COX-2 inhibitor and an alkylating-type antineoplastic agent as a combination therapy in the treatment of neoplasia
US6077850A (en) * 1997-04-21 2000-06-20 G.D. Searle & Co. Substituted benzopyran analogs for the treatment of inflammation
US20030225150A1 (en) * 1997-04-21 2003-12-04 Pharmacia Corporation Method of using a COX-2 inhibitor and a topoisomerase II inhibitor as a combination therapy in the treatment of neoplasia
US7029652B2 (en) * 1998-09-16 2006-04-18 The Regents Of The University Of California Method of treating tumors
US20020103141A1 (en) * 1998-12-23 2002-08-01 Mckearn John P. Antiangiogenic combination therapy for the treatment of cancer
US20040053900A1 (en) * 1998-12-23 2004-03-18 Pharmacia Corporation Method of using a COX-2 inhibitor and an aromatase inhibitor as a combination therapy
US6800646B1 (en) 1999-02-08 2004-10-05 Pharmacia Corporation Sulfamato hydroxamic acid metalloprotease inhibitor
AU775701B2 (en) * 1999-02-08 2004-08-12 G.D. Searle & Co. Sulfamato hydroxamic acid metalloprotease inhibitor
AU781339B2 (en) * 1999-05-12 2005-05-19 G.D. Searle & Co. Hydroxamic acid derivatives as matrix metalloprotease inhibitors
WO2000069434A1 (fr) 1999-05-17 2000-11-23 Ilex Oncology, Inc. Utilisation combinee d'eflornithine hydrochloride et de celecoxib pour la chimioprevention et le traitement du cancer
US7141581B2 (en) 1999-07-02 2006-11-28 Agouron Pharmaceuticals, Inc. Indazole compounds and pharmaceutical compositions for inhibiting protein kinases, and methods for their use
GB9920548D0 (en) * 1999-08-31 1999-11-03 Rhone Poulenc Rorer Sa Treatment of hepatocellular carcinoma
CN1391484A (zh) * 1999-09-15 2003-01-15 惠氏公司 增强化疗疗效及治疗实体瘤的方法
US7465754B1 (en) 1999-09-15 2008-12-16 Wyeth Method of potentiating chemotherapy and treating solid tumors
EP1229908A1 (fr) * 1999-11-15 2002-08-14 ADVANCED RESEARCH AND TECHNOLOGY INSTITUTE, Inc. Utilisation des ains dans le traitement du cancer du pancreas
HUP0300544A3 (en) * 2000-02-03 2005-03-29 Eisai Co Ltd Pharmaceutical compositions containing integrin expression inhibitors
AU2000237154A1 (en) * 2000-02-28 2001-09-12 Zila, Inc. Method for detecting and killing epithelial cancer cells
JP2003528926A (ja) 2000-03-24 2003-09-30 ノバルティス アクチエンゲゼルシャフト 新血管形成の改善された処置
EP1138680A1 (fr) * 2000-03-29 2001-10-04 Pfizer Products Inc. Acides gem-substitués alpha-sulfonylamino hydroxamiques comme inhibiteurs de métalloprotease
AU2001269821A1 (en) 2000-06-15 2001-12-24 Barbara Chen Cycloalkyl alkanoic acids as integrin receptor antagonists
JP5106739B2 (ja) * 2000-06-29 2012-12-26 クイック−メッド テクノロジーズ、インク． 化粧品組成物および方法
US6531494B1 (en) 2001-08-29 2003-03-11 Pharmacia Corporation Gem-substituted αvβ3 antagonists
AR034142A1 (es) * 2000-09-08 2004-02-04 Sloan Kettering Inst Cancer Una composicion farmaceutica, metodo para fabricar un medicamento en base a dicha composicion y uso de la composicion
AU8986501A (en) * 2000-09-08 2002-03-22 Pharmacia & Upjohn Spa Exemestane as chemopreventing agent
EP1377298B1 (fr) * 2001-01-26 2006-08-30 Pfizer Italia S.r.l. Exemestane pour traiter les troubles hormonodependants
CA2440555A1 (fr) 2001-03-14 2002-09-19 Bristol-Myers Squibb Company Combinaison d'analogues d'epothilones et d'agents chimiotherapeutiques servant au traitement de maladies proliferatives
US20030105144A1 (en) * 2001-04-17 2003-06-05 Ping Gao Stabilized oral pharmaceutical composition
AU2002316855B2 (en) 2001-04-24 2008-03-13 Merck Patent Gmbh Combination therapy using anti-angiogenic agents and TNFalpha
US6872730B2 (en) 2001-04-27 2005-03-29 3-Dimensional Pharmaceuticals, Inc. Substituted benzofurans and benzothiophenes, methods of making and methods of use as integrin antagonists
WO2002089824A1 (fr) * 2001-05-03 2002-11-14 F. Hoffmann-La Roche Ag Combinaison d'un inhibiteur de gelatinase et d'un antitumoral, et ses utilisations
AU2002345792A1 (en) 2001-06-21 2003-01-08 Pfizer Inc. Thienopyridine and thienopyrimidine anticancer agents
US6683078B2 (en) 2001-07-19 2004-01-27 Pharmacia Corporation Use of sulfonyl aryl or heteroaryl hydroxamic acids and derivatives thereof as aggrecanase inhibitors
EP1408975A2 (fr) * 2001-07-23 2004-04-21 Epidauros Biotechnologie AG Moyens et procedes de traitement ameliore du cancer sur la base de cyp3a5
CA2461085A1 (fr) * 2001-10-19 2003-05-01 Novartis Ag Composition pharmaceutique servant a traiter des tumeurs malignes et comprenant une combinaison de biphosphonate, d'inhibiteur de cox-2 et de taxol
IL161462A0 (en) * 2001-10-25 2004-09-27 Novartis Ag Combinations comprising a selective cyclooxygenase-2 inhibitor
PT2305255E (pt) * 2001-12-03 2012-09-04 Bayer Healthcare Llc Compostos de arilureia em combinação com outros agentes citostáticos ou citotóxicos para tratamento de cancros humanos
US20030143165A1 (en) * 2002-01-25 2003-07-31 Allan Evans NSAID-containing topical formulations that demonstrate chemopreventive activity
GB0204756D0 (en) * 2002-02-28 2002-04-17 Novartis Ag Organic compounds
BR0308162A (pt) 2002-03-01 2004-12-07 Pfizer Derivados de indolil-uréia de tienopiridinas úteis como agentes antiangiogênicos e métodos para o seu uso
US20040001835A1 (en) * 2002-03-04 2004-01-01 Medimmune, Inc. Prevention or treatment of cancer using integrin alphavbeta3 antagonists in combination with other agents
EP1485131A1 (fr) * 2002-03-08 2004-12-15 Novartis AG Inhibiteurs de la metalloproteinase matricielle en combinaison avec l'hypothermie et/ou la radiotherapie pour le traitement du cancer
WO2003082191A2 (fr) 2002-03-28 2003-10-09 Merck & Co., Inc. 2,3-diphenyl-pyridines substituees
WO2003091247A2 (fr) 2002-04-25 2003-11-06 Pharmacia Corporation Acides piperidinylsulfonylmethylhydroxamiques et piperazinylsulfonylmethylhydroxamiques et leur utilisation comme inhibiteurs de protease
UA77303C2 (en) 2002-06-14 2006-11-15 Pfizer Derivatives of thienopyridines substituted by benzocondensed heteroarylamide useful as therapeutic agents, pharmaceutical compositions and methods for their use
CA2492387A1 (fr) * 2002-07-17 2004-01-22 Warner-Lambert Company Llc Combinaison d'un inhibiteur allosterique carboxylique de la metalloproteinase matricielle 13 avec un inhibiteur selectif de la cyclooxygenase-2 qui n'est pas un celecoxib ou un valdecoxib
CA2495432A1 (fr) * 2002-07-17 2004-01-22 Warner-Lambert Company Llc Combinaison d'un inhibiteur carboxylique allosterique de metalloproteinase-13 de matrice et de celecoxibe ou de valdecoxibe
AP2005003232A0 (en) * 2002-08-19 2005-03-31 Pfizer Prod Inc Combination therapy for hyperproliferative diseases.
CN102516417B (zh) 2002-09-06 2014-12-10 天蓝制药公司 用于传递治疗剂的以环糊精为基础的聚合物
OA12977A (en) 2002-12-19 2006-10-13 Pfizer 2-(1H-indazol-6-ylamino)-benzamide compounds as protein kinases inhibitors useful for the treatment of ophthamic diseases.
EP1605951A1 (fr) * 2003-03-18 2005-12-21 Pharmacia Italia S.p.A. Polytherapie comprenant l'administration combinee de nemorubicine et d'un inhibiteur de la cyclo-oxygenase-2
DE10313272A1 (de) * 2003-03-24 2004-10-21 Baxter Healthcare S.A. Verwendung von Miltefosine zur Behandlung von aktinischer oder multiplen aktinischer Keratosen
US20050043233A1 (en) 2003-04-29 2005-02-24 Boehringer Ingelheim International Gmbh Combinations for the treatment of diseases involving cell proliferation, migration or apoptosis of myeloma cells or angiogenesis
PL1745791T3 (pl) 2003-05-07 2013-11-29 Osteologix As Leczenie chorób chrząstki/kości za pomocą rozpuszczalnych w wodzie soli strontu
US7008953B2 (en) 2003-07-30 2006-03-07 Agouron Pharmaceuticals, Inc. 3, 5 Disubstituted indazole compounds, pharmaceutical compositions, and methods for mediating or inhibiting cell proliferation
ATE412655T1 (de) 2003-08-29 2008-11-15 Pfizer Als neue antiangiogene mittel geeignete thienopyridinphenylacetamide und derivate davon
GB0321999D0 (en) * 2003-09-19 2003-10-22 Cancer Rec Tech Ltd Anti-cancer combinations
JP5015601B2 (ja) 2003-10-21 2012-08-29 セダーズ−シナイ メディカル センター 中枢神経系の癌を含む癌の処置のための系および方法
UA82577C2 (en) 2003-12-23 2008-04-25 Пфайзер Инк. Quinoline derivatives
CA2572223C (fr) 2004-06-25 2014-08-12 The Johns Hopkins University Inhibiteurs d'angiogenese
ES2341351T3 (es) 2004-08-26 2010-06-18 Pfizer, Inc. Compuestos de aminoheteroarilo enantiomericamente puros como inhibidores de proteina cinasas.
US20090047365A1 (en) * 2005-02-28 2009-02-19 Eisai R & D Management Co., Ltd. Novel Concomitant Use of Sulfonamide Compound with Anti-Cancer Agent
US7399335B2 (en) * 2005-03-22 2008-07-15 H.C. Starck Inc. Method of preparing primary refractory metal
ES2425396T3 (es) 2006-01-18 2013-10-15 Merck Patent Gmbh Terapia específica usando ligandos de integrinas para el tratamiento del cáncer
US20080051380A1 (en) 2006-08-25 2008-02-28 Auerbach Alan H Methods and compositions for treating cancer
US8129184B2 (en) 2006-09-26 2012-03-06 Cedars-Sinai Medical Center Cancer stem cell antigen vaccines and methods
WO2008039974A2 (fr) 2006-09-28 2008-04-03 Cedars-Sinai Medical Center Vaccins contre le cancer et méthodes de vaccination
DK2101805T3 (da) * 2007-01-18 2013-01-21 Merck Patent Gmbh Integrinligander til anvendelse i behandling af cancer
WO2008091530A2 (fr) * 2007-01-19 2008-07-31 Mallinckrodt Inc. Ligands de liaison à la cycloxygénase-2 diagnostiques et thérapeutiques
US20080176958A1 (en) 2007-01-24 2008-07-24 Insert Therapeutics, Inc. Cyclodextrin-based polymers for therapeutics delivery
CN101641599A (zh) * 2007-03-23 2010-02-03 霍夫曼-拉罗奇有限公司 作为肺癌标志物的apex
GB2462235B8 (en) * 2007-05-11 2013-03-27 Biotechnology Res Corp Ltd Receptor modulators exhibiting neuroprotective andmemory enhancing activities
ES2428896T3 (es) * 2007-11-16 2013-11-12 Ube Industries, Ltd. Compuesto de benzacepinona
CA2740028A1 (fr) 2008-01-23 2009-07-30 Herlev Hospital Ykl-40 en tant que marqueur general pour une maladie non specifique
US20110070601A1 (en) * 2008-01-23 2011-03-24 Rigshospitalet Classification of individuals suffering from cardiovascular diseases according to survival prognoses as found by measuring the levels of biomarker ykl-40
MX339476B (es) 2008-04-18 2016-05-27 Reata Pharmaceuticals Inc Compuestos que incluyen un nucleo farmaceutico antiinflamatorio y sus metodos de uso.
WO2010028066A2 (fr) 2008-09-02 2010-03-11 Cedars-Sinai Medical Center Épitopes cd133
CA2737292A1 (fr) 2008-09-15 2010-03-18 Herlev Hospital Ykl-40 en tant que marqueur pour les cancers gastro-intestinaux
US9782565B2 (en) 2008-10-01 2017-10-10 Covidien Lp Endoscopic ultrasound-guided biliary access system
US11298113B2 (en) 2008-10-01 2022-04-12 Covidien Lp Device for needle biopsy with integrated needle protection
US9332973B2 (en) 2008-10-01 2016-05-10 Covidien Lp Needle biopsy device with exchangeable needle and integrated needle protection
US8968210B2 (en) * 2008-10-01 2015-03-03 Covidien LLP Device for needle biopsy with integrated needle protection
US9186128B2 (en) * 2008-10-01 2015-11-17 Covidien Lp Needle biopsy device
ES2618573T3 (es) 2009-05-07 2017-06-21 ImmunoCellular Therapeutics,Ltd Epítopos de CD133
CA2761946A1 (fr) * 2009-05-14 2010-11-18 The Regents Of The University Of California, A California Corporation Diagnostic et traitements du carcinome sur la base du genotype odc1
JP5572996B2 (ja) * 2009-05-15 2014-08-20 宇部興産株式会社 ベンズアゼピノン化合物を有効成分として含有する医薬
JP2012528079A (ja) 2009-05-25 2012-11-12 メルク パテント ゲゼルシャフト ミット ベシュレンクテル ハフツング 癌を治療するためのインテグリンリガンドの連続投与
PT3150610T (pt) 2010-02-12 2019-11-11 Pfizer Sais e polrmorfos de 8-fluor0-2-{4- [(metilamino}metil]fenil}-1,3,4,5-tetrahidr0-6hazepin0[ 5,4,3-cd]indol-6-0na
US8515525B2 (en) * 2011-08-16 2013-08-20 Women's Imaging Solutions Enterprises Llc Skin adhesive agent for mammography procedures
KR20140103122A (ko) 2011-11-17 2014-08-25 넨키 인스티튜트 오브 익스페리멘탈 바이올로지 신경교종을 치료하기 위한 조성물 및 방법
JP6215324B2 (ja) 2012-07-18 2017-10-18 セントルイス ユニバーシティ インテグリンアンタゴニストとしてのβアミノ酸誘導体
US8716226B2 (en) 2012-07-18 2014-05-06 Saint Louis University 3,5 phenyl-substituted beta amino acid derivatives as integrin antagonists
WO2014055493A1 (fr) 2012-10-02 2014-04-10 Cerulean Pharma Inc. Procédés et systèmes s'appliquant à la précipitation de polymères et à la génération de particules
TWI646091B (zh) 2012-12-28 2019-01-01 日商衛斯克慧特股份有限公司 鹽類及晶形
EP2956544B1 (fr) 2013-02-14 2017-11-01 Immunocellular Therapeutics Ltd. Vaccins contre le cancer et méthodes de vaccination
WO2014127785A1 (fr) 2013-02-20 2014-08-28 Ganymed Pharmaceuticals Ag Polythérapie impliquant des anticorps dirigés contre la claudine 18,2 pour le traitement du cancer
HRP20211836T1 (hr) 2013-09-24 2022-03-04 Fujifilm Corporation Novi spoj koji sadrži dušik ili njegova sol, ili njegov metalni kompleks
US20170065723A1 (en) * 2013-09-27 2017-03-09 Cerulean Pharma Inc. Treatment of cancer
US10421971B2 (en) 2014-01-15 2019-09-24 The University Of Chicago Anti-tumor therapy
EP3233829B1 (fr) 2014-12-18 2019-08-14 Pfizer Inc Dérivés de pyrimidine et de triazine, et leur utilisation comme inhibiteurs d'axl
JP2018536707A (ja) 2015-10-30 2018-12-13 キャンサー プリベンション ファーマシューティカルズ，インコーポレイテッド エフロルニチンとスリンダクの固定用量複合製剤
US9782370B2 (en) * 2015-12-21 2017-10-10 Gongwin Biopharm Holdings Co., Ltd. Pharmaceutical compositions of benzenesulfonamide derivatives for treatment of adenoid cystic carcinoma
WO2017117130A1 (fr) 2015-12-28 2017-07-06 The United States Of America, As Represented By The Secretary, Department Of Health & Human Services Procédés d'inhibition de libération de virus de l'immunodéficience humaine (vih) à partir de cellules infectées
CA3008023A1 (fr) 2015-12-30 2017-07-06 Saint Louis University Derives d'acide aminobenzoique meta-azacyclique a titre d'antagonistes de pan-integrine
WO2017155935A1 (fr) * 2016-03-07 2017-09-14 The Johns Hopkins University Agents pharmaceutiques ciblant des cellules souches cancéreuses
US20170273926A1 (en) * 2016-03-24 2017-09-28 Orbus Therapeutics, Inc. Compositions and methods for use of eflornithine and derivatives and analogs thereof to treat cancers, including gliomas
CA3031705A1 (fr) 2016-07-29 2018-02-01 Janssen Pharmaceutica Nv Traitement du cancer de la prostate a l'aide de niraparib
US10668039B2 (en) 2016-09-02 2020-06-02 The Children's Medical Center Corporation Methods for treatment of adenoid cystic carcinoma
EP3523274A4 (fr) 2016-10-06 2020-05-13 Orbus Therapeutics, Inc. Formulations pour l'administration d'eflornithine
CN106389429A (zh) * 2016-12-02 2017-02-15 郑州莉迪亚医药科技有限公司 一种治疗老年痴呆症的西药组合物及其应用
WO2019040319A1 (fr) * 2017-08-25 2019-02-28 The Regents Of The University Of California Procédés d'amélioration d'une chimiothérapie anticancéreuse
CN111777615B (zh) * 2020-07-20 2022-04-19 济南大学 一种检测环氧合酶2的光动力治疗探针及其制备
CN114767868B (zh) * 2022-03-30 2023-04-18 宁夏医科大学 Cox-2抑制剂与化疗药物在制备抗肿瘤药物中的应用
WO2024184889A1 (fr) * 2023-03-08 2024-09-12 Ariel Scientific Innovations Ltd. Méthodes de traitement

Family Cites Families (96)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2465486A1 (fr) 1979-09-21 1981-03-27 Roussel Uclaf Nouvelle application utilisant la lh-rh ou des agonistes
DE3121153A1 (de) 1981-05-22 1982-12-09 Schering Ag, 1000 Berlin Und 4619 Bergkamen "verwendung von aromatase-hemmern zur prophylaxe und therapie der prostatahyperplasie"
US4659695A (en) 1985-02-08 1987-04-21 Fernand Labrie Method of treatment of prostate cancer
US4775660A (en) 1984-08-02 1988-10-04 Fernand Labrie Treatment of breast cancer by combination therapy
US4760053A (en) 1984-08-02 1988-07-26 Fernand Labrie Combination therapy for selected sex steroid dependent cancers
US5039805A (en) 1988-12-08 1991-08-13 Hoffmann-La Roche Inc. Novel benzoic and phenylacetic acid derivatives
US5084466A (en) 1989-01-31 1992-01-28 Hoffmann-La Roche Inc. Novel carboxamide pyridine compounds which have useful pharmaceutical utility
CA2008116C (fr) 1989-02-23 2001-11-20 Thomas Weller Derives de glycine
US5686566A (en) 1989-06-16 1997-11-11 Cor Therapeutics, Inc. Platelet aggregation inhibitors
US5061693A (en) 1989-07-28 1991-10-29 Merck & Co., Inc. Fibrinogen receptor antagonists
CA2037153A1 (fr) 1990-03-09 1991-09-10 Leo Alig Derives de l'acide acetique
US5612311A (en) 1990-04-06 1997-03-18 La Jolla Cancer Research Foundation Method and composition for treating thrombosis
US5721210A (en) 1990-07-09 1998-02-24 Tanabe Seiyaku Co., Ltd. Cyclic cell adhesion modulation compounds
US5229366A (en) 1990-10-23 1993-07-20 Fuji Photo Film Co., Ltd. Peptide-containing polyethylene glycol derivatives and application thereof
US5294713A (en) 1991-08-23 1994-03-15 Takeda Chemical Industries, Ltd. 2-piperazinone compounds and their use
CA2078817A1 (fr) 1991-10-18 1993-04-19 Beat A. Imhof Anticorps anti-.alpha.6-integrine
US5663166A (en) 1991-10-18 1997-09-02 Genentech, Inc. Nonpeptidyl integrin inhibitors having specificity for the GPIIb IIIa receptor
JPH07103148B2 (ja) 1991-12-16 1995-11-08 株式会社ディ・ディ・エス研究所 アントラサイクリン−マクロライド複合体
US5965132A (en) 1992-03-05 1999-10-12 Board Of Regents, The University Of Texas System Methods and compositions for targeting the vasculature of solid tumors
US5225531A (en) 1992-04-09 1993-07-06 Washington University Hexapeptide Lys Gly Ala Gly Asp Val
HUT64977A (en) 1992-07-30 1994-03-28 Yeda Res & Dev Synthetical peptone derivatives of vitronectine and pharmaceutical preparaties containing them
AU5292193A (en) * 1992-10-02 1994-04-26 Merck & Co., Inc. N-(mercaptoacyl)peptidyl derivatives as antidegenerative agents
JPH06116289A (ja) 1992-10-09 1994-04-26 Fuji Photo Film Co Ltd 細胞接着性ペプチド配列複合体とその用途
WO1994012169A1 (fr) * 1992-11-25 1994-06-09 Merck & Co., Inc. Derives de carboxy-peptidyle utilises comme agents anti-degeneratifs actifs
TW301607B (fr) 1993-03-09 1997-04-01 Takeda Pharm Industry Co Ltd
DE4310632A1 (de) 1993-04-01 1994-10-06 Merck Patent Gmbh Lineare Adhäsionsinhibitoren
DE4310643A1 (de) 1993-04-01 1994-10-06 Merck Patent Gmbh Cyclische Adhäsionsinhibitoren
ES2134870T3 (es) 1993-05-01 1999-10-16 Merck Patent Gmbh Antagonistas del receptor de adhesion.
DE4332384A1 (de) 1993-09-23 1995-03-30 Merck Patent Gmbh Adhäsionsrezeptor-Antagonisten III
US5536814A (en) 1993-09-27 1996-07-16 La Jolla Cancer Research Foundation Integrin-binding peptides
DE4336758A1 (de) 1993-10-28 1995-05-04 Merck Patent Gmbh Lineare Adhäsionsinhibitoren
SI0656348T1 (en) 1993-12-03 2000-08-31 F. Hoffmann-La Roche Ag Aceric acid derivatives as medicaments
JP3235319B2 (ja) 1994-01-14 2001-12-04 大正製薬株式会社 チアゾリン誘導体
JP3750144B2 (ja) 1994-01-14 2006-03-01 大正製薬株式会社 ３−アリールチアゾリン誘導体
DE4405378A1 (de) 1994-02-19 1995-08-24 Merck Patent Gmbh Adhäsionsrezeptor-Antagonisten
JPH07285992A (ja) 1994-02-25 1995-10-31 Snow Brand Milk Prod Co Ltd 新規ペプチド
US5753230A (en) * 1994-03-18 1998-05-19 The Scripps Research Institute Methods and compositions useful for inhibition of angiogenesis
US5770565A (en) 1994-04-13 1998-06-23 La Jolla Cancer Research Center Peptides for reducing or inhibiting bone resorption
DE4415310A1 (de) 1994-04-30 1995-11-02 Merck Patent Gmbh Cyclopeptide
EP0760658B1 (fr) 1994-05-27 2002-11-13 Merck & Co. Inc. Composes inhibiteurs de la resorption osseuse induite par osteoclaste
US5990112A (en) * 1996-06-18 1999-11-23 Affymax Technologies N.V. Inhibitors of metalloproteases pharmaceutical compositions comprising same and methods of their use
US5510332A (en) 1994-07-07 1996-04-23 Texas Biotechnology Corporation Process to inhibit binding of the integrin α4 62 1 to VCAM-1 or fibronectin and linear peptides therefor
US5464855A (en) 1994-08-09 1995-11-07 Warner-Lambert Company Thiophene-2-carboxamidotetrazoles and pharmaceutical use thereof
US5639726A (en) 1994-09-30 1997-06-17 The Regents Of The University Of Michigan Peptide mediated enhancement of thrombolysis methods and compositions
DK0710657T3 (da) 1994-11-02 1999-05-25 Merck Patent Gmbh Adhæsionsreceptor-antagonister
DE4439846A1 (de) 1994-11-08 1996-05-09 Merck Patent Gmbh Adhäsionsrezeptor-Antagonisten
US5574026A (en) 1994-12-13 1996-11-12 American Cyanamid Company Methods for inhibiting angiogenesis proliferation of endothelial or tumor cells and tumor growth
JPH08183752A (ja) 1994-12-28 1996-07-16 Sumitomo Pharmaceut Co Ltd シクロヘキサン誘導体
JPH08183788A (ja) 1994-12-28 1996-07-16 Sumitomo Pharmaceut Co Ltd １−オキサ−６−アザスピロ〔２．５〕オクタン誘導体
DE19504954A1 (de) 1995-02-15 1996-08-22 Merck Patent Gmbh Adhäsionsrezeptor-Antagonisten
DE19516483A1 (de) 1995-05-05 1996-11-07 Merck Patent Gmbh Adhäsionsrezeptor-Antagonisten
US5817750A (en) 1995-08-28 1998-10-06 La Jolla Cancer Research Foundation Structural mimics of RGD-binding sites
MX9801716A (es) 1995-08-30 1998-05-31 Searle & Co Derivados de meta-guanidina, urea, tiourea o acido aminobenzoico azaciclico, como antagonistas de integrina.
US6013651A (en) 1995-08-30 2000-01-11 G. D. Searle & Co. Meta-azacyclic amino benzoic acid compounds and derivatives thereof
US6100423A (en) 1995-08-30 2000-08-08 G. D. Searle & Co. Amino benzenepropanoic acid compounds and derivatives thereof
DE19534016A1 (de) 1995-09-14 1997-03-20 Merck Patent Gmbh Biotinderivate
DE19534177A1 (de) 1995-09-15 1997-03-20 Merck Patent Gmbh Cyclische Adhäsionsinhibitoren
EP0765660A3 (fr) 1995-09-28 1998-09-23 Takeda Chemical Industries, Ltd. Microcapsules contenant des acides 2-pipérazinone-1-yl-acétiques
DE19539091A1 (de) 1995-10-20 1997-04-24 Thomae Gmbh Dr K 5-gliedrige Heterocyclen, diese Verbindungen enthaltende Arzneimittel und deren Verwendung sowie Verfahren zur ihrer Herstellung
ATE230389T1 (de) 1995-10-25 2003-01-15 Senju Pharma Co Angiogenese inhibitoren
SI0874830T1 (en) * 1995-12-08 2003-08-31 Agouron Pharmaceuticals, Inc. A metalloproteinase inhibitor, a pharmaceutical composition containing it and the pharmaceutical use and method useful for the preparation thereof
US5760028A (en) 1995-12-22 1998-06-02 The Dupont Merck Pharmaceutical Company Integrin receptor antagonists
DE19626701A1 (de) 1996-07-03 1998-01-08 Hoechst Ag Neue Inhibitoren der Knochenresorption und Vitronectinrezeptor-Antagonisten
EP0796855B1 (fr) 1996-03-20 2002-02-06 Hoechst Aktiengesellschaft Inhibiteurs de la résorption osseuse et antagonistes du récepteur de la vitronectine
WO1997036858A1 (fr) 1996-03-29 1997-10-09 G.D. Searle & Co. Derives de l'acide alcanoique de cyclopropyle
AU2536097A (en) 1996-03-29 1997-10-22 G.D. Searle & Co. Para-substituted phenylpropanoic acid derivatives as integrin antagonists
PT889876E (pt) 1996-03-29 2001-11-30 Searle & Co Derivados de fenilenossulfonamidas meta-substituidas
JP2000506538A (ja) 1996-03-29 2000-05-30 ジー．ディー．サール アンド カンパニー メタ―置換フェニレン誘導体
DE69713582T2 (de) 1996-03-29 2003-01-09 G.D. Searle & Co., Chicago Zimtsäurederivate und deren verwendung als integrin-antagonisten
DE19613933A1 (de) 1996-04-06 1997-10-09 Merck Patent Gmbh Cyclische Adhäsionsinhibitoren
US5925655A (en) 1996-04-10 1999-07-20 Merck & Co., Inc. αv β3 antagonists
WO1997041844A1 (fr) * 1996-05-09 1997-11-13 Alcon Laboratories, Inc. Combinaisons de composes angiostatiques
DE19654483A1 (de) 1996-06-28 1998-01-02 Merck Patent Gmbh Phenylalanin-Derivate
DK0912495T3 (da) 1996-07-12 2002-05-21 Searle & Co Asymmetrisk syntese af chirale beta-aminosyrer
DE19629816A1 (de) 1996-07-24 1998-01-29 Hoechst Ag Neue Cycloalkyl-Derivate als Inhibitoren der Knochenresorption und Vitronectinrezeptor-Antagonisten
DE19629817A1 (de) 1996-07-24 1998-01-29 Hoechst Ag Neue Imino-Derivate als Inhibitoren der Knochenresorption und Vitronectinrezeptor-Antagonisten
UA60311C2 (uk) * 1996-10-02 2003-10-15 Смітклайн Бічам Корпорейшн Антагоністи рецептора вітронектину, спосіб одержання цих сполук та фармацевтична композиція
IL154501A0 (en) * 1996-10-15 2003-09-17 Searle & Co Use of cyclooxygenase-2 inhibitors for the manufacture of a medicament for the treatment and prevention of neoplasia
US5919792A (en) 1996-10-30 1999-07-06 Merck & Co., Inc. Integrin antagonists
KR20000053362A (ko) * 1996-11-19 2000-08-25 윌리암스 로저 에이 항 맥관형성제로서 시클로옥시게나제-2 저해제의 이용 방법
ES2321991T3 (es) 1996-12-09 2009-06-15 Merck Patent Gmbh Receptor de adhesion alfavbet3 recombinante soluble.
DE19653646A1 (de) 1996-12-20 1998-06-25 Hoechst Ag Substituierte Purinderivate, Verfahren zu deren Herstellung, sie enthaltende Mittel und deren Verwendung
DE19653645A1 (de) 1996-12-20 1998-06-25 Hoechst Ag Vitronectin - Rezeptorantagonisten, deren Herstellung sowie deren Verwendung
DE19653647A1 (de) 1996-12-20 1998-06-25 Hoechst Ag Vitronectin - Rezeptorantagonisten, deren Herstellung sowie deren Verwendung
US5837696A (en) * 1997-01-15 1998-11-17 The Research Foundation Of State University Of New York Method of inhibiting cancer growth
US6017925A (en) * 1997-01-17 2000-01-25 Merck & Co., Inc. Integrin antagonists
EP1007026A4 (fr) * 1997-01-17 2002-08-07 Merck & Co Inc Antagonistes d'integrine
AU1110799A (en) * 1997-10-29 1999-05-17 Warner-Lambert Company Method of inhibiting metastases of cancer cells
PL341379A1 (en) * 1997-11-14 2001-04-09 Searle & Co Aromatic sulphone substituted hydroxamic acid as inhibitor of metalloprotease
ATE298338T1 (de) * 1997-12-17 2005-07-15 Merck & Co Inc Integrin-rezeptor-antagonisten
NZ333399A (en) * 1997-12-24 2000-05-26 Sankyo Co Cyclooxygenase-2 inhibitors (COX-2) for the prevention and treatment of tumors, cachexia and tumor-metastasis
SI0928793T1 (en) 1998-01-02 2002-10-31 F. Hoffmann-La Roche Ag Thiazole derivatives
US6372719B1 (en) * 1998-03-04 2002-04-16 Jay Cunningham ανβ3 integrin antagonists in combination with chemotherapeutic agents
NZ507292A (en) * 1998-04-10 2003-12-19 G Heterocyclic glycyl beta-alanine derivatives useful as vitronectin antagonists
EP1100506A4 (fr) * 1998-07-29 2002-06-26 Merck & Co Inc Antagonistes des recepteurs de l'integrine
US6277878B1 (en) * 1998-09-07 2001-08-21 Pfizer Inc Substituted indole compounds as anti-inflammatory and analgesic agents

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2047271B1 (fr) * 2006-08-02 2012-11-14 Sanoxsys GmbH Procédé de détermination de la sensibilité de tumeurs à la capécitabine
WO2014150996A1 (fr) * 2013-03-15 2014-09-25 Cba Pharma, Inc. Traitement contre le cancer

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EP1140179A2 (fr) 2001-10-10
JP2002533406A (ja) 2002-10-08
CA2356302A1 (fr) 2000-07-06
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IL143870A0 (en) 2002-04-21
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IL143901A0 (en) 2002-04-21
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US6689787B1 (en) 2004-02-10
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CA2356426A1 (fr) 2000-06-29
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